English national health service's savings plan may have helped reduce the use of three 'low-value' procedures

Health Affairs

Volumn 34, Issue 3, 2015, Pages 381-389

  Coronini Cronberg, Sophie ^a,b   Bixby, Honor ^a   Laverty, Anthony A ^a   Wachter, Robert M ^c,d   Millett, Christopher ^a  

^a IMPERIAL COLLEGE LONDON   (United Kingdom)

^b Centre Medical Directorate   (United Kingdom)

^c UNIVERSITY OF CALIFORNIA   (United States)

^d Hospital Medicine   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGED; ARTICLE; BUDGET; CATARACT EXTRACTION; CHOLECYSTECTOMY; CLINICAL EFFECTIVENESS; COST CONTROL; COST EFFECTIVENESS ANALYSIS; ELECTIVE SURGERY; FEMALE; GENDER; GROUPS BY AGE; HEALTH CARE COST; HEALTH CARE ORGANIZATION; HEALTH CARE SYSTEM; HERNIOPLASTY; HIP ARTHROPLASTY; HUMAN; HYSTERECTOMY; MAJOR CLINICAL STUDY; MALE; MIDDLE AGED; MYRINGOTOMY; NATIONAL HEALTH SERVICE; REVASCULARIZATION; SOCIAL STATUS; SPINE SURGERY; TREND STUDY; VERY ELDERLY; YOUNG ADULT; ECONOMICS; HEALTH CARE SURVEY; HEALTH INSURANCE; ORGANIZATION AND MANAGEMENT; OUTCOME ASSESSMENT; PROCEDURES; STATISTICS AND NUMERICAL DATA; UNITED KINGDOM;

ADULT; AGED; AGED, 80 AND OVER; COST SAVINGS; ELECTIVE SURGICAL PROCEDURES; FEMALE; HEALTH CARE SURVEYS; HEALTH EXPENDITURES; HUMANS; MALE; MIDDLE AGED; OUTCOME ASSESSMENT (HEALTH CARE); SINGLE-PAYER SYSTEM; STATE MEDICINE; UNITED KINGDOM; YOUNG ADULT;

EID: 84924613932     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2014.0773     Document Type: Article

References (48)

1. Centers for Medicare and Medicaid Services. National health expenditures 2012 highlights [Internet]. Baltimore (MD): CMS; [cited 2015 Jan 21]. Available from: http:// www.cms.gov/Research-Statistics- Data-and-Systems/Statistics-Trendsand- Reports/NationalHealth ExpendData/Downloads/highlights.pdf
2. Morse A. Progress making NHS efficiency savings. London: National Audit Office; 2012 Dec 13.
3. Chandra A, Holmes J, Skinner J. Is this time different? The slowdown in healthcare spending [Internet]. Cambridge (MA): National Bureau of Economic Research; 2013 Dec [cited 2015 Jan 21]. (NBER Working Paper No. 19700). Available from: http:// www.nber.org/papers/w19700.pdf
4. Appleby J. Spending on health and social care over the next 50 years: why think long term? London: King's Fund; 2013 Jan 31.
5. Institute of Medicine. Best care at lower cost: the path to continuously learning health care in America. Washington (DC): National Academies Press; 2012.
6. Cassel CK, Guest JA. Choosing Wisely: helping physicians and patients make smart decisions about their care. JAMA. 2012;307(17): 1801-2.
7. Chambers JD, Lord J, Cohen JT, Neumann PJ, Buxton MJ. Illustrating potential efficiency gains from using cost-effectiveness evidence to reallocate Medicare expenditures. Value Health. 2013;16(4):629-38.
8. Garner S, Littlejohns P. Disinvestment from low value clinical interventions: NICEly done? BMJ. 2011;343:d4519.
9. Stabile M, Thomson S, Allin S, Boyle S, Busse R, Chevreul K, et al. Health care cost containment strategies used in four other high-income countries hold lessons for the United States. Health Aff (Millwood). 2013;32(4):643-52.
10. Morse A. Delivering efficiency savings in the NHS. London: National Audit Office; 2011 Sep.
11. Malhotra N, Jacobson B. Save to invest: developing criteria-based commissioning for planned health care in London [Internet]. London: London Health Observatory; 2007 Jun [cited 2015 Jan 30]. Available from: http://www.lho.org.uk/ Download/Public/11626/1/Save %20to%20Invest%20(Executive %20Summary).pdf
12. Gray M, Swift S, Suleman M, Beasley N, Hakes D, Qualie M, et al. Value based clinical commissioning of elective surgical care: emerging views of commissioners and surgeons and production of high value care pathways [Internet]. London: Department of Health; [cited 2015 Jan 21]. Available from: http:// www.rightcare.nhs.uk/wp-content/ uploads/2011/12/Right_Care_ Elective_Surgery_Phase1_report.pdf
13. Royal College of Surgeons of England. Procedures of limited clinical value: Royal College of Surgeons briefing [Internet]. London: RCS; 2011 [cited 2015 Jan 28]. Available from: https://www.rcseng.ac.uk/ publications/docs/rcs-briefingprocedures- of-limited-clinical-value/ @@download/pdffile/RCS%20 Briefing%20-%20Procedures%20 of%20a%20Limited%20Clinical %20Value%20-%20Jan%2011.pdf
14. Russell J, Swinglehurst D, Greenhalgh T. "Cosmetic boob jobs" or evidence-based breast surgery: an interpretive policy analysis of the rationing of "low value" treatments in the English National Health Service. BMC Health Serv Res. 2014;14:413.
15. National Health Service. NHS Better Care, Better Value Indicators (incorporating Opportunity Locator): national: dashboard: managing surgical thresholds [Internet]. Coventry: NHS; 2013 [cited 2015 Jan 28] Available from: http://www.productivity.nhs.uk/PCT_ Dashboard/DetailedView?practice Code=National&pctCode= National&percentileId=2&year QtrId=21&indicatorId=613& indicatorTypeId=2
16. National Institute for Health and Care Excellence. NICE "do not do" recommendations [Internet]. London: NICE; [last updated 2012 Sep 25; cited 2015 Jan 21]. Available from: https://www.nice.org.uk/ proxy/?sourceurl=http://www.nice.org.uk/usingguidance/donotdo recommendations/index.jsp
17. Jones S, Ap Dewi S, Jones C, Cosh H, Gibbon R, Charles J, et al. Demand and variation in elective surgical procedures. Cardiff: Public Health Wales; 2010 Apr 12.
18. National Institute for Health and Care Excellence. Heavy menstrual bleeding: NICE clinical guideline 44. London: NICE; 2007 Jan.
19. National Institute for Health and Care Excellence. The care and management of osteoarthritis in adults: NICE clinical guideline 59. London: NICE; 2008 Feb.
20. Audit Commission. Reducing spending on low clinical value treatments. London: Audit Commission; 2011 Apr.
21. Department of Health. National service framework for coronary heart disease. London: The Department; 2000 Mar 14.
22. Blackledge HM. Coronary revascularisation: need and provision in the East Midlands: update 2008 [Internet]. Mansfield: East Midlands Public Health Observatory; 2008 Oct [cited 2015 Jan 21]. (Briefing Paper). Available for download from: http:// www.empho.org.uk/download.aspx?urlid=11077&urlt=1
23. Health and Social Care Information Centre. Hospital Episode Statistics [Internet]. Leeds: HSCIC; [cited 2015 Jan 21]. Available from: http:// www.hscic.gov.uk/hes
24. To access the Appendix, click on the Appendix link in the box to the right of the article online.
25. Office for National Statistics. Primary Care Organisation population estimates (experimental) [Internet]. Newport (Wales): ONS; 2013 [cited 2015 Jan 21]. Available from: http:// www.ons.gov.uk/ons/rel/sape/pcopop- est-exp/index.html
26. McLennan D, Barnes H, Noble M, Davies J, Garratt E. The English indices of deprivation 2010. London: Department for Communities and Local Government; 2011 Mar 24.
27. Gov.UK. Statistics: English indices of deprivation 2010: PCT summaries [Internet]. London: Department for Communities and Local Government; 2011 Mar 24 [cited 2015 Jan 28]. Available for download from: https://www.gov.uk/ government/uploads/system/ uploads/attachment_data/file/ 15242/1981203.xls
28. Flory D. The quarter: quarter 4 2009/10. London: Department of Health; 2010 Oct 12.
29. Badrinath P, Currell RA, Bradley PM. Characteristics of primary care trusts in financial deficit and surplus-a comparative study in the English NHS. BMC Health Serv Res. 2006;6:64.
30. Garner S, Docherty M, Somner J, Sharma T, Choudhury M, Clarke M, et al. Reducing ineffective practice: challenges in identifying low-value health care using Cochrane systematic reviews. J Health Serv Res Policy. 2013;18(1):6-12.
31. Elshaug AG, Watt AM, Mundy L, Willis CD. Over 150 potentially lowvalue health care practices: an Australian study. Med J Aust. 2012; 197(10):556-60.
32. Rooshenas L, Owen-Smith A, Donovan J, Hollingworth W. Saving money in the NHS: a qualitative investigation of disinvestment practices, and barriers to change. Lancet. 2013;382(special issue):S18.
33. Audit Commission. Data remember: improving the quality of patientbased information in the NHS. London: Audit Commission; 2002 Mar.
34. Spencer A. Hospital Episode Statistics (HES): improving the quality and value of hospital data. Leeds: Health and Social Care Information Centre; 2012.
35. Burns EM, Rigby E, Mamidanna R, Bottle A, Aylin P, Ziprin P, et al. Systematic review of discharge coding accuracy. J Public Health (Oxf). 2012;34(1):138-48.
36. Polisena J, Clifford T, Elshaug AG, Mitton C, Russell E, Skidmore B. Case studies that illustrate disinvestment and resource allocation decision-making processes in health care: a systematic review. Int J Technol Assess Health Care. 2013; 29(2):174-84.
37. Thornhill MH, Dayer MJ, Forde JM, Corey GR, Chu VH, Couper DJ, et al. Impact of the NICE guideline recommending cessation of antibiotic prophylaxis for prevention of infective endocarditis: before and after study. BMJ. 2011;342:d2392.
38. Schwartz AL, Landon BE, Elshaug AG, Chernew ME, McWilliams JM. Measuring low-value care in Medicare. JAMA Intern Med. 2014; 174(7):1067-76.
39. American Academy of Family Physicians. Choosing Wisely: fifteen things patients and physicians should question [Internet]. Leawood (KS): AAFP; [cited 2015 Jan 21]. Available from: http://www.aafp.org/dam/AAFP/documents/about_ us/initiatives/choosing-wiselyfifteen- questions.pdf
40. Squires DA. Explaining high health care spending in the United States: an international comparison of supply, utilization, prices, and quality [Internet]. New York (NY): Commonwealth Fund; 2012 May [cited 2015 Jan 21]. Available from: http://www.commonwealthfund.org/~/media/files/publications/ issue-brief/2012/may/1595_ squires_explaining_high_hlt_ care_spending_intl_brief.pdf
41. Lorenzoni L, Belloni A, Sassi F. Health-care expenditure and health policy in the USA versus other highspending OECD countries. Lancet. 2014;384(9937):83-92.
42. Joynt KE, Jha AK. A path forward on Medicare readmissions. N Engl J Med. 2013;368(13):1175-7.
43. Schoen C, Doty MM. Inequities in access to medical care in five countries: findings from the 2001 Commonwealth Fund International Health Policy Survey. Health Policy. 2004;67(3):309-22.
44. National Institute for Health and Care Excellence. NICE Implementation Collaborative-Concordat. London: NICE; 2012.
45. Patients Association. The waiting game: the results of Patients Association research into elective surgery procedures [Internet]. Harrow (England): Patients Association; [cited 2015 Jan 21]. Available from: http://www.patients-association.com/wp-content/uploads/2014/07/ The-Waiting-Game.pdf
46. Mooney H. NHS framework reintroduces target of treating 92% of patients within 18 weeks. BMJ. 2011;343:d7712.
47. National Health Service. Consultantled referral to treatment: waiting times data 2011-12 [Internet]. London: NHS; [cited 2015 Jan 214]. Available from: http://www.england.nhs.uk/statistics/ statistical-work-areas/rtt-waitingtimes/ rtt-data-2011-12/
48. Morden NE, Colla CH, Sequist TD, Rosenthal MB. Choosing Wisely- the politics and economics of labeling low-value services. N Engl J Med. 2014;370(7):589-92.