Research Article: What does high value care for musculoskeletal conditions mean and how do you apply it in practice? A consensus statement from a research network of physiotherapists in New South Wales, Australia
Abstract:
Objectives To develop a physiotherapist-led consensus statement on the definition and provision of high-value care for people with musculoskeletal conditions. Design We performed a three-stage study using Research And Development/University of California Los Angeles Appropriateness Method methodology. We reviewed evidence about current definitions through a rapid literature review and then performed a survey and interviews with network members to gather consensus. Consensus was finalised in a face-to-face meeting. Setting Australian primary care. Participants Registered physiotherapists who are members of a practice-based research network (n=31). Results The rapid review revealed two definitions, four domains of high value care and seven themes of high-quality care. Online survey responses (n=26) and interviews (n=9) generated two additional high-quality care themes, a definition of low-value care, and 21 statements on the application of high value care. Consensus was reached for three working definitions (high value, high-quality and low value care), a final model of four high value care domains (high-quality care, patient values, cost-effectiveness, reducing waste), nine high-quality care themes and 15 statements on application. Conclusion High value care for musculoskeletal conditions delivers most value for the patient, and the clinical benefits outweigh the costs to the individual or system providing the care. High-quality care is evidence based, effective and safe care that is patient-centred, consistent, accountable, timely, equitable and allows easy interaction with healthcare providers and healthcare systems.
Introduction:
Musculoskeletal conditions are prevalent and are the leading cause of years lost to disability worldwide. 1 2 Due to population growth and ageing, the global musculoskeletal burden is predicted to increase. 1–5 Healthcare spending associated with musculoskeletal care typically outstrips spending on other health conditions. 6–10 To address the growing musculoskeletal burden, there are increasing calls to provide high value care. 11–15 High value care aims to provide cost-effective care that optimises patient…
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