Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service?
<h4>Background</h4> Health systems are under pressure to maintain services within limited resources. The Evidence-Based Interventions (EBI) programme published a first list of guidelines in 2019, which aimed to reduce inappropriate use of interventions within the NHS in England, reducing...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10473535/?tool=EBI |
| _version_ | 1797690824063975424 |
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| author | Joel Glynn Timothy Jones Mike Bell Jane Blazeby Christopher Burton Carmel Conefrey Jenny L. Donovan Nicola Farrar Josie Morley Angus McNair Amanda Owen-Smith Ellen Rule Gail Thornton Victoria Tucker Iestyn Williams Leila Rooshenas William Hollingworth |
| author_facet | Joel Glynn Timothy Jones Mike Bell Jane Blazeby Christopher Burton Carmel Conefrey Jenny L. Donovan Nicola Farrar Josie Morley Angus McNair Amanda Owen-Smith Ellen Rule Gail Thornton Victoria Tucker Iestyn Williams Leila Rooshenas William Hollingworth |
| author_sort | Joel Glynn |
| collection | DOAJ |
| description | <h4>Background</h4> Health systems are under pressure to maintain services within limited resources. The Evidence-Based Interventions (EBI) programme published a first list of guidelines in 2019, which aimed to reduce inappropriate use of interventions within the NHS in England, reducing potential harm and optimising the use of limited resources. Seventeen procedures were selected in the first round, published in April 2019. <h4>Methods</h4> We evaluated changes in the trends for each procedure after its inclusion in the EBI’s first list of guidelines using interrupted time series analysis. We explored whether there was any evidence of spill-over effects onto related or substitute procedures, as well as exploring changes in geographical variation following the publication of national guidance. <h4>Results</h4> Most procedures were experiencing downward trends in the years prior to the launch of EBI. We found no evidence of a trend change in any of the 17 procedures following the introduction of the guidance. No evidence of spill-over increases in substitute or related procedures was found. Geographic variation in the number of procedures performed across English CCGs remained at similar levels before and after EBI. <h4>Conclusions</h4> The EBI programme had little success in its aim to further reduce the use of the 17 procedures it deemed inappropriate in all or certain circumstances. Most procedure rates were already decreasing before EBI and all continued with a similar trend afterwards. Geographical variation in the number of procedures remained at a similar level post EBI. De-adoption of inappropriate care is essential in maintaining health systems across the world. However, further research is needed to explore context specific enablers and barriers to effective identification and de-adoption of such inappropriate health care to support future de-adoption endeavours. |
| first_indexed | 2024-03-12T02:05:40Z |
| format | Article |
| id | doaj.art-e27735bb16af494996b3dd106e6790e0 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-12T02:05:40Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-e27735bb16af494996b3dd106e6790e02023-09-07T05:31:41ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01189Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service?Joel GlynnTimothy JonesMike BellJane BlazebyChristopher BurtonCarmel ConefreyJenny L. DonovanNicola FarrarJosie MorleyAngus McNairAmanda Owen-SmithEllen RuleGail ThorntonVictoria TuckerIestyn WilliamsLeila RooshenasWilliam Hollingworth<h4>Background</h4> Health systems are under pressure to maintain services within limited resources. The Evidence-Based Interventions (EBI) programme published a first list of guidelines in 2019, which aimed to reduce inappropriate use of interventions within the NHS in England, reducing potential harm and optimising the use of limited resources. Seventeen procedures were selected in the first round, published in April 2019. <h4>Methods</h4> We evaluated changes in the trends for each procedure after its inclusion in the EBI’s first list of guidelines using interrupted time series analysis. We explored whether there was any evidence of spill-over effects onto related or substitute procedures, as well as exploring changes in geographical variation following the publication of national guidance. <h4>Results</h4> Most procedures were experiencing downward trends in the years prior to the launch of EBI. We found no evidence of a trend change in any of the 17 procedures following the introduction of the guidance. No evidence of spill-over increases in substitute or related procedures was found. Geographic variation in the number of procedures performed across English CCGs remained at similar levels before and after EBI. <h4>Conclusions</h4> The EBI programme had little success in its aim to further reduce the use of the 17 procedures it deemed inappropriate in all or certain circumstances. Most procedure rates were already decreasing before EBI and all continued with a similar trend afterwards. Geographical variation in the number of procedures remained at a similar level post EBI. De-adoption of inappropriate care is essential in maintaining health systems across the world. However, further research is needed to explore context specific enablers and barriers to effective identification and de-adoption of such inappropriate health care to support future de-adoption endeavours.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10473535/?tool=EBI |
| spellingShingle | Joel Glynn Timothy Jones Mike Bell Jane Blazeby Christopher Burton Carmel Conefrey Jenny L. Donovan Nicola Farrar Josie Morley Angus McNair Amanda Owen-Smith Ellen Rule Gail Thornton Victoria Tucker Iestyn Williams Leila Rooshenas William Hollingworth Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service? PLoS ONE |
| title | Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service? |
| title_full | Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service? |
| title_fullStr | Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service? |
| title_full_unstemmed | Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service? |
| title_short | Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service? |
| title_sort | did the evidence based intervention ebi programme reduce inappropriate procedures lessen unwarranted variation or lead to spill over effects in the national health service |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10473535/?tool=EBI |
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