Chalmers Kelsey, Badgery-Parker Tim, Pearson Sallie-Anne, Brett Jonathan, Scott Ian A, Elshaug Adam G
Menzies Centre for Health Policy, School of Public Health, Charles Perkins Centre, University of Sydney, Sydney, NSW, 2006, Australia.
Health Market Quality Program, Capital Markets Cooperative Research Centre, Sydney, NSW, 2000, Australia.
BMC Res Notes. 2018 Mar 5;11(1):163. doi: 10.1186/s13104-018-3270-4.
Low-value health care refers to interventions where the risk of harm or costs exceeds the likely benefit for a patient. We aimed to develop indicators of low-value care, based on selected Choosing Wisely (CW) recommendations, applicable to routinely collected, hospital claims data.
We assessed 824 recommendations from the United States, Canada, Australia and the United Kingdom CW lists regarding their capacity to be measured in administrative hospital admissions datasets. We selected recommendations if they met the following criteria: the service occurred in the hospital setting (observable in setting); a claim recorded the use of the service (record of service); the appropriate/inappropriate use of the service could be mapped to information within the hospital claim (indication); and the service is consistently recorded in the claims (consistent documentation). We identified 17 recommendations (15 services) as measurable. We then developed low-value care indicators for two hospital datasets based on the selected recommendations, previously published indicators, and clinical input.
低价值医疗保健是指对患者造成伤害的风险或成本超过可能带来的益处的干预措施。我们旨在根据选定的“明智选择”（CW）建议，制定适用于常规收集的医院理赔数据的低价值医疗保健指标。
我们评估了来自美国、加拿大、澳大利亚和英国CW清单的824条建议，以确定它们在医院行政入院数据集里的可测量性。如果建议符合以下标准，我们就会选择它们：该服务发生在医院环境中（在环境中可观察到）；理赔记录了该服务的使用情况（服务记录）；该服务的适当/不适当使用可以映射到医院理赔中的信息（指征）；并且该服务在理赔中得到一致记录（一致的文档记录）。我们确定了17条可测量的建议（15项服务）。然后，我们根据选定的建议、先前公布的指标和临床意见，为两个医院数据集制定了低价值医疗保健指标。
