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Reporting of costs and economic impacts in randomized trials of de-implementation interventions for low-value care : a systematic scoping review |
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| Author: | Falkenbach, Petra1; Raudasoja, Aleksi J.2; Vernooij, Robin W. M.3,4; |
| Organizations: |
1Finnish Coordinating Center for Health Technology Assessment, Oulu University Hospital, University of Oulu, Oulu, Finland 2Finnish Medical Society Duodecim, Faculty of Medicine, University of Helsinki, Helsinki, Finland 3Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands
4Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
5Mehiläinen Oy, Helsinki, Finland 6Department of Medicine, Division of General Internal Medicine, McMaster University, Hamilton, ON, Canada 7Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada 8Department of Urology, University of Fukui Faculty of Medical Sciences, Fukui, Japan 9Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands 10Department of Gynaecology, Chelsea and Westminster NHS Foundation Trust, London, UK 11Department of Surgery, Division of Urology/Uro-Oncology, School of Medicine, Universidad del Valle, Cali, Colombia 12Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland 13Department of Radiology, Faculty of Medicine and Health Technologies, Imaging Centre, Tampere University Hospital, Tampere University, Tampere, Finland 14Finnish Medical Society Duodecim, Helsinki, Finland 15Wellbeing Services County of Pirkanmaa, Unit of Health Sciences, Faculty of Social Sciences, Hatanpää Health Center, Tampere University, Tampere, Finland 16Department of Dentistry and Oral Health, Oral Health Care, Institute of Dentistry, Aarhus University, University of Eastern, Kuopio, Finland 17Division of Urology, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Canada 18Departments of Surgery and Health Research Methods Evidence and Impact, McMaster University, Hamilton, Canada 19Department of Surgery, South Karelian Central Hospital, Lappeenranta, Finland 20Oulu University Hospital, University of Oulu, Oulu, Finland |
| Format: | article |
| Version: | published version |
| Access: | open |
| Online Access: | PDF Full Text (PDF, 1.6 MB) |
| Persistent link: | http://urn.fi/urn:nbn:fi-fe20231023141023 |
| Language: | English |
| Published: |
Springer Nature,
2023
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| Publish Date: | 2023-10-23 |
| Description: |
AbstractBackground: De-implementation of low-value care can increase health care sustainability. We evaluated the reporting of direct costs of de-implementation and subsequent change (increase or decrease) in health care costs in randomized trials of de-implementation research. Methods: We searched MEDLINE and Scopus databases without any language restrictions up to May 2021. We conducted study screening and data extraction independently and in duplicate. We extracted information related to study characteristics, types and characteristics of interventions, de-implementation costs, and impacts on health care costs. We assessed risk of bias using a modified Cochrane risk-of-bias tool. Results: We screened 10,733 articles, with 227 studies meeting the inclusion criteria, of which 50 included information on direct cost of de-implementation or impact of de-implementation on health care costs. Studies were mostly conducted in North America (36%) or Europe (32%) and in the primary care context (70%). The most common practice of interest was reduction in the use of antibiotics or other medications (74%). Most studies used education strategies (meetings, materials) (64%). Studies used either a single strategy (52%) or were multifaceted (48%). Of the 227 eligible studies, 18 (8%) reported on direct costs of the used de-implementation strategy; of which, 13 reported total costs, and 12 reported per unit costs (7 reported both). The costs of de-implementation strategies varied considerably. Of the 227 eligible studies, 43 (19%) reported on impact of de-implementation on health care costs. Health care costs decreased in 27 studies (63%), increased in 2 (5%), and were unchanged in 14 (33%). Conclusion: De-implementation randomized controlled trials typically did not report direct costs of the de-implementation strategies (92%) or the impacts of de-implementation on health care costs (81%). Lack of cost information may limit the value of de-implementation trials to decision-makers. Trial registration: OSF (Open Science Framework): https://osf.io/ueq32. see all
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| Series: |
Implementation science |
| ISSN: | 1748-5908 |
| ISSN-E: | 1748-5908 |
| ISSN-L: | 1748-5908 |
| Volume: | 18 |
| Article number: | 36 |
| DOI: | 10.1186/s13012-023-01290-3 |
| OADOI: | https://oadoi.org/10.1186/s13012-023-01290-3 |
| Type of Publication: |
A2 Review article in a scientific journal |
| Field of Science: |
3141 Health care science |
| Subjects: | |
| Funding: |
Open Access funding provided by University of Oulu including Oulu University Hospital. This research is funded by the Strategic Research Council (SRC) (numbers 335288, 336278, 336281). The funding source was not involved in the study design; collection, analysis, and interpretation of data; writing the report; nor in the decision to submit the article for publication. |
| Academy of Finland Grant Number: |
335288 336278 336281 |
| Detailed Information: |
335288 (Academy of Finland Funding decision) 336278 (Academy of Finland Funding decision) 336281 (Academy of Finland Funding decision) |
| Copyright information: |
© The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
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https://creativecommons.org/licenses/by/4.0/ |