Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/17045
The use of risk sharing tools for post adoption surveillance of a non pharmacological technology in routine practice: results after one year
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eISSN: 1472-6963
WOS ID: 000319519200001
Scopus EID: 2-s2.0-84877852853
PMID: 23688287
Embase PUI: L603061041
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2013-05-20Document type
research articleCitation
Campillo-Artero C, Kovacs FM. The use of risk sharing tools for post adoption surveillance of a non pharmacological technology in routine practice: results after one year. BMC Health Serv Res. 2013 May 20;13:181.Abstract
Background: To report results obtained by combining risk sharing tools with post-adoption surveillance mechanisms in order to control quality of care and implement a value-based reimbursement scheme for Neuroreflexotherapy (NRT), a non-pharmacological treatment proven effective for neck pain (NP), thoracic pain (TP) and low back pain (LBP). Methods: Pre-post prospective cohort study in routine clinical practice, carried out in primary care centers in the Spanish National Health Service in the Balearic Islands (Ib-Salut). Eight-hundred and seventy-one subacute and chronic NP, TP and LBP patients treated in Ib-Salut, who underwent NRT during 2011. A shared risk contract (SRC) was developed, where payments for NRT were linked to results on patients' clinical evolution, reduction in medication and proportion of patients undergoing spinal surgery. Main outcome measures were local pain (NP, TP or LBP), referred pain, LBP-related disability and NP-related disability, measured using previously validated instruments at referral and 3 months later, use of medication assessed at referral and discharge, and rates of spinal surgery prescription after undergoing NRT. Results: Median improvements at discharge corresponded to 57.1% of baseline value for local pain, 75.0% for referred pain, 53.8% for LBP-related disability and 45.0% for NP-related disability. Patients taking medication at discharge represented 29.0% of those taking it at referral. The proportion of patients in whom spinal surgery was prescribed after undergoing NRT was 0%. These results were consistent with those from previous randomised controlled trials (RCTs) and studies in routine practice, and complied with the standards set in the SRC. Conclusions: It is feasible and effective to enhance post adoption surveillance methods with risk sharing tools to improve quality control and support value-based reimbursement decisions for NRT. The feasibility of generalising this approach to other settings and to other non-pharmacological treatments should be explored.
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https://dx.doi.org/10.1186/1472-6963-13-181MeSH
AgedSpain
Humans
Middle Aged
National Health Programs
Pain Measurement
Pain
Male
Disability Evaluation
Prospective Studies
Quality of Health Care
Referral and Consultation
Reflexotherapy
Female
Treatment Outcome
Patient Discharge
DeCS
Resultado del TratamientoFemenino
Programas Nacionales de Salud
Evaluación de la Discapacidad
Masculino
Humanos
Persona de Mediana Edad
Dimensión del Dolor
Estudios Prospectivos
Calidad de la Atención de Salud
Derivación y Consulta
Reflejoterapia
Anciano
Dolor
Alta del Paciente
España