BACKGROUND Healthcare systems have difficulty incorporating scientific evidence into clinical practice, especially when science suggests that existing clinical practices are of low-value (e.g. ineffective or harmful to patients). While a number of lists outlining low-value practices in acute care medicine currently exist, less is known about how best to initiate and sustain the removal of low-v...

PURPOSE Medicare's merit-based incentive payment system and narrowing of physician networks by health insurers will stoke clinicians' and policy makers' interest in care delivery attributes associated with value as defined by payers. METHODS To help define these attributes, we analyzed 2009 to 2011 commercial health insurance claims data for more than 40 million preferred provider organizatio...

background nosocomial infections increase mortality rate in neonates. studies have attributed the use of h2 blockers as one of the various factors that increase the risk of nosocomial infections. objectives to define the relationship between nosocomial infection and ranitidine in very low birth weight (vlbw) infants admitted in the nicu of a tertiary care hospital. patients and methods all vlbw...

To enhance the value of care provided to Americans, the American Board of Internal Medicine and Consumer Reports launched the Choosing Wisely® initiative in 2012. Choosing Wisely educates providers and patients about high-frequency, low-value care practices that can be avoided to decrease cost and increase the value of health care. The Oncology Nursing Society collaborated with the American Aca...

AN INTERNATIONAL GROUNDSWELL OF ACTIVITY IS seeking to identify and reduce the use of health care services that provide little or no benefit— whether through overuse or misuse. There are strong imperatives for identifying such waste: (1) an ethical imperative to ensure patient safety and thus avoid tests and treatments that cause harm directly or indirectly without providing commensurate benefi...

There is growing recognition in the academic literature that critical decisions concerning resource allocation and resource management in health and care are influenced by a range of contextual factors. In their paper in this journal, Williams et al define these ‘decisions of value’ as being characterized by a significant and demonstrable impact on quality and resources in health and care. ‘Dec...

More than 40 medical specialties have identified "Choosing Wisely" lists of five overused or low-value services. But these services vary widely in potential impact on care and spending, and specialty societies often name other specialties' services as low value.