Clavel, N., De Coster, C., Pomey MP, Sanmartin C, Noseworthy, T., Bohm, E., Franck, C. (2016). «Appropriateness for total joint replacement: Perspectives of decision-makers», Healthcare Policy; 11(3): 80-92. 10.12927/hcpol.2016.24522
Abstract
Background: Improving access to total joint replacement (TJR) has been a priority. Without robust mechanisms to ensure appropriateness, these procedures may be overused, incur- ring substantial costs. In that context, decision-makers are particularly concerned with the appropriateness of TJR.
Objective: While our previous research focused on the appropriateness of TJR from clinical and patient perspectives, this study is aimed at understanding decision-makers’ perspectives.
Methods: Using a semi-structured guide, we interviewed a convenience sample of decision- makers in four Canadian provinces (Alberta, Manitoba, Nova Scotia and Quebec) between February and March 2013. For the purposes of this study, a decision-maker was defined as a manager, institutional leader or policy maker.
Results: Fifteen interviews were conducted with decision-makers at ministry (n = 3), regional (n = 6) and institutional levels (n = 8). Decision-makers see themselves as having a key role in the appropriateness discourse, that of optimizing resource allocation and efficient delivery of services for TJR, to improve population outcomes.
Conclusion: The decision-makers’ view of appropriateness recognizes the importance of the clinical view, but it offers a very different input into the appropriateness discourse, more closely aligned with appropriateness of setting, which refers to cost-effectiveness considerations.
This content has been updated on 19 January 2018 at 11 h 09 min.