Subcategorizing the Expected Value of Perfect Implementation to Identify When and Where to Invest in Implementation Initiatives.
Purpose. Clinical practice variations and low implementation of effective and cost-effective health care technologies are a key challenge for health care systems and may lead to suboptimal treatment and health loss for patients. The purpose of this work was to subcategorize the expected value of per...
| Published in: | Medical Decision Making Vol. 40; no. 3; pp. 327 - 339 |
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| Main Authors: | , , , |
| Format: | case study equations & formulas research tables/charts Journal Article |
| Published: |
Sage Publications Inc.
Apr2020
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=143347994&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 143347994 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0272989X DKI jtl: Medical Decision Making issn: 0272989X maglogo: Y pubinfo: dt: Apr2020 vid: 40 iid: 3 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 143347994 143347994 146268042 143347994 10.1177/0272989X20907353 143347994 ppf: 327 ppct: 12 formats: tig: atl: Subcategorizing the Expected Value of Perfect Implementation to Identify When and Where to Invest in Implementation Initiatives. aug: au: Johannesen, Kasper Janzon, Magnus Jernberg, Tomas Henriksson, Martin affil: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden sug: subj: Implementation Science Program Implementation Cost Benefit Analysis Health Care Delivery Methods Human Conceptual Framework Platelet Aggregation Inhibitors Administration and Dosage Myocardial Infarction Prevention and Control Quality-Adjusted Life Years Decision Making ab: Purpose. Clinical practice variations and low implementation of effective and cost-effective health care technologies are a key challenge for health care systems and may lead to suboptimal treatment and health loss for patients. The purpose of this work was to subcategorize the expected value of perfect implementation (EVPIM) to enable estimation of the absolute and relative value of eliminating slow, low, and delayed implementation. Methods. Building on the EVPIM framework, this work defines EVPIM subcategories to estimate the expected value of eliminating slow, low, or delayed implementation. The work also shows how information on regional implementation patterns can be used to estimate the value of eliminating regional implementation variation. The application of this subcategorization is illustrated by a case study of the implementation of an antiplatelet therapy for the secondary prevention after myocardial infarction in Sweden. Incremental net benefit (INB) estimates are based on published cost-effectiveness assessments and a threshold of SEK 250,000 (£22,300) per quality-adjusted life year (QALY). Results. In the case study, slow, low, and delayed implementation was estimated to represent 22%, 34%, and 44% of the total population EVPIM (2941 QALYs or SEK 735 million), respectively. The value of eliminating implementation variation across health care regions was estimated to 39% of total EVPIM (1138 QALYs). Conclusion. Subcategorizing EVPIM estimates the absolute and relative value of eliminating different parts of suboptimal implementation. By doing so, this approach could help decision makers to identify which parts of suboptimal implementation are contributing most to total EVPIM and provide the basis for assessing the cost and benefit of implementation activities that may address these in future implementation of health care interventions. pubtype: Academic Journal doctype: case study equations & formulas research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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