Addressing overuse of health services in health systems : a critical interpretive synthesis
ABSTRACT: Background: Health systems are increasingly focusing on the issue of ‘overuse’ of health services and how to address it. We developed a framework focused on (1) the rationale and context for health systems prioritising addressing overuse, (2) elements of a comprehensive process and approac...
- Autores:
-
Ellen, Moriah E.
Gordon Wilson, Michael
Vélez, Claudia Marcela
Shach, Ruth
Lavis, John N.
Grimshaw, Jeremy M.
Moat, Kaelan A.
- Tipo de recurso:
- Review article
- Fecha de publicación:
- 2018
- Institución:
- Universidad de Antioquia
- Repositorio:
- Repositorio UdeA
- Idioma:
- eng
- OAI Identifier:
- oai:bibliotecadigital.udea.edu.co:10495/21554
- Acceso en línea:
- http://hdl.handle.net/10495/21554
- Palabra clave:
- Servicios de Salud
Health Services
Uso Excesivo de los Servicios de Salud
Medical Overuse
Política de Salud
Health Policy
- Rights
- openAccess
- License
- http://creativecommons.org/licenses/by/2.5/co/
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|
dc.title.spa.fl_str_mv |
Addressing overuse of health services in health systems : a critical interpretive synthesis |
title |
Addressing overuse of health services in health systems : a critical interpretive synthesis |
spellingShingle |
Addressing overuse of health services in health systems : a critical interpretive synthesis Servicios de Salud Health Services Uso Excesivo de los Servicios de Salud Medical Overuse Política de Salud Health Policy |
title_short |
Addressing overuse of health services in health systems : a critical interpretive synthesis |
title_full |
Addressing overuse of health services in health systems : a critical interpretive synthesis |
title_fullStr |
Addressing overuse of health services in health systems : a critical interpretive synthesis |
title_full_unstemmed |
Addressing overuse of health services in health systems : a critical interpretive synthesis |
title_sort |
Addressing overuse of health services in health systems : a critical interpretive synthesis |
dc.creator.fl_str_mv |
Ellen, Moriah E. Gordon Wilson, Michael Vélez, Claudia Marcela Shach, Ruth Lavis, John N. Grimshaw, Jeremy M. Moat, Kaelan A. |
dc.contributor.author.none.fl_str_mv |
Ellen, Moriah E. Gordon Wilson, Michael Vélez, Claudia Marcela Shach, Ruth Lavis, John N. Grimshaw, Jeremy M. Moat, Kaelan A. |
dc.subject.decs.none.fl_str_mv |
Servicios de Salud Health Services Uso Excesivo de los Servicios de Salud Medical Overuse Política de Salud |
topic |
Servicios de Salud Health Services Uso Excesivo de los Servicios de Salud Medical Overuse Política de Salud Health Policy |
dc.subject.agrovoc.none.fl_str_mv |
Health Policy |
description |
ABSTRACT: Background: Health systems are increasingly focusing on the issue of ‘overuse’ of health services and how to address it. We developed a framework focused on (1) the rationale and context for health systems prioritising addressing overuse, (2) elements of a comprehensive process and approach to reduce overuse and (3) implementation considerations for addressing overuse. Methods: We conducted a critical interpretive synthesis informed by a stakeholder-engagement process. The synthesis identified relevant empirical and non-empirical articles about system-level overuse. Two reviewers independently screened records, assessed for inclusion and conceptually mapped included articles. From these, we selected a purposive sample, created structured summaries of key findings and thematically synthesised the results. Results: Our search identified 3545 references, from which we included 251. Most articles (76%; n = 192) were published within 5 years of conducting the review and addressed processes for addressing overuse (63%; n = 158) or political and health system context (60%; n = 151). Besides negative outcomes at the patient, system and global level, there were various contextual factors to addressing service overuse that seem to be key issue drivers. Processes for addressing overuse can be grouped into three elements comprising a comprehensive approach, including (1) approaches to identify overused health services, (2) stakeholder- or patient-led approaches and (3) government-led initiatives. Key implementation considerations include the need to develop ‘buy in’ from stakeholders and citizens. Conclusions: Health systems want to ensure the use of high-value services to keep citizens healthy and avoid harm. Our synthesis can be used by policy-makers, stakeholders and researchers to understand how the issue has been prioritised, what approaches have been used to address it and implementation considerations. |
publishDate |
2018 |
dc.date.issued.none.fl_str_mv |
2018 |
dc.date.accessioned.none.fl_str_mv |
2021-08-06T11:25:18Z |
dc.date.available.none.fl_str_mv |
2021-08-06T11:25:18Z |
dc.type.spa.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.coar.fl_str_mv |
http://purl.org/coar/resource_type/c_2df8fbb1 |
dc.type.coarversion.fl_str_mv |
http://purl.org/coar/version/c_970fb48d4fbd8a85 |
dc.type.hasversion.spa.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.coar.spa.fl_str_mv |
http://purl.org/coar/resource_type/c_dcae04bc |
dc.type.redcol.spa.fl_str_mv |
https://purl.org/redcol/resource_type/ARTREV |
dc.type.local.spa.fl_str_mv |
Artículo de revisión |
format |
http://purl.org/coar/resource_type/c_dcae04bc |
status_str |
publishedVersion |
dc.identifier.issn.none.fl_str_mv |
1478-4505 |
dc.identifier.uri.none.fl_str_mv |
http://hdl.handle.net/10495/21554 |
dc.identifier.doi.none.fl_str_mv |
10.1186/s12961-018-0325-x |
identifier_str_mv |
1478-4505 10.1186/s12961-018-0325-x |
url |
http://hdl.handle.net/10495/21554 |
dc.language.iso.spa.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartofjournalabbrev.spa.fl_str_mv |
Health Res. Policy Syst. |
dc.rights.spa.fl_str_mv |
info:eu-repo/semantics/openAccess |
dc.rights.uri.*.fl_str_mv |
http://creativecommons.org/licenses/by/2.5/co/ |
dc.rights.accessrights.spa.fl_str_mv |
http://purl.org/coar/access_right/c_abf2 |
dc.rights.creativecommons.spa.fl_str_mv |
https://creativecommons.org/licenses/by/4.0/ |
eu_rights_str_mv |
openAccess |
rights_invalid_str_mv |
http://creativecommons.org/licenses/by/2.5/co/ http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by/4.0/ |
dc.format.extent.spa.fl_str_mv |
14 |
dc.format.mimetype.spa.fl_str_mv |
application/pdf |
dc.publisher.spa.fl_str_mv |
BMC |
dc.publisher.group.spa.fl_str_mv |
Grupo Académico de Epidemiología Clínica |
dc.publisher.place.spa.fl_str_mv |
Londres, Inglaterra |
institution |
Universidad de Antioquia |
bitstream.url.fl_str_mv |
http://bibliotecadigital.udea.edu.co/bitstream/10495/21554/1/license_rdf http://bibliotecadigital.udea.edu.co/bitstream/10495/21554/2/license.txt http://bibliotecadigital.udea.edu.co/bitstream/10495/21554/3/VelezClaudia_2018_AddressingOveruseHealthServices.pdf |
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Repositorio Institucional Universidad de Antioquia |
repository.mail.fl_str_mv |
andres.perez@udea.edu.co |
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1812173162024009728 |
spelling |
Ellen, Moriah E.Gordon Wilson, MichaelVélez, Claudia MarcelaShach, RuthLavis, John N.Grimshaw, Jeremy M.Moat, Kaelan A.2021-08-06T11:25:18Z2021-08-06T11:25:18Z20181478-4505http://hdl.handle.net/10495/2155410.1186/s12961-018-0325-xABSTRACT: Background: Health systems are increasingly focusing on the issue of ‘overuse’ of health services and how to address it. We developed a framework focused on (1) the rationale and context for health systems prioritising addressing overuse, (2) elements of a comprehensive process and approach to reduce overuse and (3) implementation considerations for addressing overuse. Methods: We conducted a critical interpretive synthesis informed by a stakeholder-engagement process. The synthesis identified relevant empirical and non-empirical articles about system-level overuse. Two reviewers independently screened records, assessed for inclusion and conceptually mapped included articles. From these, we selected a purposive sample, created structured summaries of key findings and thematically synthesised the results. Results: Our search identified 3545 references, from which we included 251. Most articles (76%; n = 192) were published within 5 years of conducting the review and addressed processes for addressing overuse (63%; n = 158) or political and health system context (60%; n = 151). Besides negative outcomes at the patient, system and global level, there were various contextual factors to addressing service overuse that seem to be key issue drivers. Processes for addressing overuse can be grouped into three elements comprising a comprehensive approach, including (1) approaches to identify overused health services, (2) stakeholder- or patient-led approaches and (3) government-led initiatives. Key implementation considerations include the need to develop ‘buy in’ from stakeholders and citizens. Conclusions: Health systems want to ensure the use of high-value services to keep citizens healthy and avoid harm. Our synthesis can be used by policy-makers, stakeholders and researchers to understand how the issue has been prioritised, what approaches have been used to address it and implementation considerations.COL000712114application/pdfengBMCGrupo Académico de Epidemiología ClínicaLondres, Inglaterrainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://purl.org/coar/resource_type/c_dcae04bchttp://purl.org/coar/resource_type/c_2df8fbb1https://purl.org/redcol/resource_type/ARTREVArtículo de revisiónhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by/2.5/co/http://purl.org/coar/access_right/c_abf2https://creativecommons.org/licenses/by/4.0/Addressing overuse of health services in health systems : a critical interpretive synthesisServicios de SaludHealth ServicesUso Excesivo de los Servicios de SaludMedical OverusePolítica de SaludHealth PolicyHealth Res. Policy Syst.Health Research Policy and Systems11416CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8927http://bibliotecadigital.udea.edu.co/bitstream/10495/21554/1/license_rdf1646d1f6b96dbbbc38035efc9239ac9cMD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://bibliotecadigital.udea.edu.co/bitstream/10495/21554/2/license.txt8a4605be74aa9ea9d79846c1fba20a33MD52ORIGINALVelezClaudia_2018_AddressingOveruseHealthServices.pdfVelezClaudia_2018_AddressingOveruseHealthServices.pdfArtículo de revisiónapplication/pdf1274961http://bibliotecadigital.udea.edu.co/bitstream/10495/21554/3/VelezClaudia_2018_AddressingOveruseHealthServices.pdfda2e5d7ee947456f6d57be5728affeebMD5310495/21554oai:bibliotecadigital.udea.edu.co:10495/215542021-08-06 06:25:19.584Repositorio Institucional Universidad de Antioquiaandres.perez@udea.edu.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 |