Background: Through the Choosing Wisely Canada (CWC) campaign, national medical specialty societies have released hundreds of recommendations against health care services that are unnecessary, i.e. present little to no benefit or cause avoidable harm. Despite growing interest in unnecessary care both within Canada and internationally, prior research has typically avoided taking a national or even multi-jurisdictional approach in measuring the extent of the issue. This study estimates use of three unnecessary services identified by CWC recommendations across multiple Canadian jurisdictions.
Methods: Two retrospective cohort studies were conducted using administrative health care data collected between fiscal years 2011/12 and 2012/13 to respectively quantify use of 1) diagnostic imaging (spinal X-ray, CT or MRI) among Albertan patients following a visit for lower back pain and 2) cardiac tests (electrocardiogram, chest X-ray, stress test, or transthoracic echocardiogram) prior to low-risk surgical procedures in Alberta, Saskatchewan, and Ontario. A cross-sectional study of the 2012 Canadian Community Health Survey was also conducted to estimate 3) the proportion of females aged 40-49 that reported having a routine mammogram in the past two years.
Results: Use of unnecessary care was relatively frequent across all three services and jurisdiction measured: 30.7% of Albertan patients had diagnostic imaging within six months of their initial visit for lower back pain; a cardiac test preceded 17.9 to 35.5% of low-risk surgical procedures across Alberta, Saskatchewan, and Ontario; and 22.2% of Canadian women aged 40-49 at average-risk for breast cancer reported having a routine screening mammogram in the past two years.
Conclusions: The use of potentially unnecessary care appears to be common in Canada. This investigation provides methodology to facilitate future measurement efforts that may incorporate additional jurisdictions and/or unnecessary services.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610789 | PMC |
| http://dx.doi.org/10.1186/s12913-019-4277-9 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Development of a Screening Intervention for Dysphagia in Hospitalised Geriatric Patients.
Dysphagia
January 2025
The Unit of Health Promotion, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark.
Prevalence of dysphagia is high in hospitalised geriatric patients, posing risks of complications including malnutrition, dehydration, aspiration, and pneumonia. These complications may lead to reduced daily functioning, frailty, prolonged hospital stays, readmissions, and mortality. Diagnosing dysphagia in geriatric patients is often challenging due to the complex health conditions of this patient group, and overall these patients are at risk of lack of continuity in patient pathways and unnecessary hospitalisations.
View Article and Find Full Text PDFAwaiting insurance coverage: Medicaid enrollment and post-acute care use after traumatic injury.
J Trauma Acute Care Surg
January 2025
From the Section of Trauma and Acute Care Surgery, Department of Surgery (D.N.H., J.S.H.), University of Chicago, Chicago, Illinois; Perelman School of Medicine (E.C.E., A.T.C., O.I.R., A.U.M., M.K.D., N.D.M., M.J.S., E.J.K.), Division of Trauma, Surgical Critical Care and Emergency Surgery (K.M.C., N.D.M., M.J.S., E.J.K.), University of Pennsylvania, Philadelphia, Pennsylvania; and Department of Surgery (L.M.K.), Stanford University, Stanford, California.
Background: Lack of insurance after traumatic injury is associated with decreased use of postacute care and poor outcomes. Insurance linkage programs enroll eligible patients in Medicaid at the time of an unplanned admission. We hypothesized that Medicaid enrollment would be associated with increased use of postacute care, but also with prolonged hospital length of stay (LOS) while awaiting insurance authorization.
View Article and Find Full Text PDFA quality improvement initiative aimed at reducing service strain and improving physician wellness in internal medicine.
BMC Med Educ
January 2025
Division of General Internal Medicine, Department of Medicine, The Ottawa Hospital, Ottawa, Canada.
Introduction: Hospital strain has been shown to negatively impact physician wellness, educational experience, and patient care. To address rising service demands, a non-academic hospitalist service was implemented to reduce daily clinical teaching unit (CTU) census by approximately 30%. Secondary aims were to evaluate physician and trainee wellness on CTU as well as assess unintended adverse patient outcomes.
View Article and Find Full Text PDFAccuracy of nursing diagnoses identified at admission and discharge of patients with decompensated heart failure.
Int J Nurs Knowl
January 2025
Paulista Nursing School, Federal University of São Paulo, São Paulo, São Paulo, Brasil.
Purpose: To determine the accuracy of nursing diagnoses at hospital admission and discharge for patients with heart failure (HF).
Methods: This comparative study examined the documentation in 155 medical records of patients with an admitting diagnosis of HF during August 2018 and July 2019. An audit tool was used to record the diagnoses made by nurses during routine care at the time of admission and discharge.
Objectives: To assess the contemporary malignancy rate in isolated de novo red patches in the bladder and associated risk factors for better selection of red patch biopsy.
Patients: Patients from the IDENTIFY dataset; Patients referred to secondary care with suspected urinary tract cancer and found to have isolated de novo red patches on cystoscopy.
Methods: We reported the unadjusted cancer prevalence in isolated de novo red patches that were biopsied; multivariable logistic regression was used to explore cancer-associated risk factors including age, sex, smoking, type of haematuria, LUTS, UTIs and a suspicious-looking red patch (as reported by the cystoscopist).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!