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The use of risk sharing tools for post adoption surveillance of a non pharmacological technology in routine practice: results after one year
- Source :
- BMC Health Services Research
- Publisher :
- Springer Nature
-
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.
- Subjects :
- Male
medicine.medical_specialty
Referral
National Health Programs
humanos
Pain
Disability Evaluation
reflexoterapia
estudios prospectivos
valoración de discapacidades
alta de pacientes
Medicine
dolor
Humans
Prospective Studies
Medical prescription
Prospective cohort study
Referral and Consultation
Reimbursement
mediana edad
Aged
Pain Measurement
Quality of Health Care
Neck pain
anciano
Referred pain
business.industry
resultado del tratamiento
Health Policy
Middle Aged
Low back pain
Patient Discharge
Neuroreflexotherapy
medida del dolor
Outcome and Process Assessment, Health Care
Treatment Outcome
Spain
Physical therapy
Female
medicine.symptom
business
Reflexotherapy
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Volume :
- 13
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....43beee9b283df2b24108b13890b4dce6
- Full Text :
- https://doi.org/10.1186/1472-6963-13-181