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Appropriateness in health care: Application to prescribing

Author

Listed:
  • Buetow, Stephen A.
  • Sibbald, Bonnie
  • Cantrill, Judith A.
  • Halliwell, Shirley

Abstract

To help account for and address observed variations in medical practice, evaluations of "appropriateness" have sought to supplement incomplete evidence with professional opinion. This article contributes to an understanding and refinement of the construct of appropriateness by discussing how it has been defined and applied in studies of health care in general and prescribing in particular. We suggest that appropriateness is the outcome of a process of decisiondashmaking that maximises net individual health gains within society's available resources. This definition distinguishes between (in)appropriate prescribing, as an outcome, and (ir)rational prescribing as a process. To assess appropriateness, we advocate combining explicit criteria with independent review in cases of uncertainty and disagreement. Refinements based on reviews using implicit criteria should draw on shared professional knowledge and post hoc state the process followed as explicitly as possible. The Medication Appropriateness Index is shown to provide a solid foundation for identifying dimensions of prescribing appropriateness.

Suggested Citation

  • Buetow, Stephen A. & Sibbald, Bonnie & Cantrill, Judith A. & Halliwell, Shirley, 1997. "Appropriateness in health care: Application to prescribing," Social Science & Medicine, Elsevier, vol. 45(2), pages 261-271, July.
    • Handle: RePEc:eee:socmed:v:45:y:1997:i:2:p:261-271
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    Citations

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    Cited by:

    1. Wenwei Liu & Suwei Yuan & Fengqing Wei & Jing Yang & Zhe Zhang & Changbin Zhu & Jin Ma, 2015. "Reliability and Validity of the Chinese Version Appropriateness Evaluation Protocol," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-11, August.
    2. Claudio Lucifora & Antonio Russo & Daria Vigani, 2021. "Does prescribing appropriateness reduce health expenditures? Main effects and unintended outcomes," DISCE - Working Papers del Dipartimento di Economia e Finanza def103, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    3. Beatriz González López-Valcárcel & Anselmo López Cabañas & Antonio Cabeza Mora & José Antonio Díaz Berenguer & Vicente Ortún & Fayna Álamo Santana, 2005. "Drug utilization studies and data registries in primary care," Economics Working Papers 809, Department of Economics and Business, Universitat Pompeu Fabra.
    4. Rosella Levaggi & Michele Moretto & Paolo Pertile, 2012. "DRGs: the link between investment in technologies and appropriateness," Working Papers 31/2012, University of Verona, Department of Economics.
    5. Loris Tramite & Rosa Caterina Marmo & Roberta Giordana & Rocco Palumbo, 2017. "I nuovi Livelli Essenziali di Assistenza (L.E.A.) tra economicit? ed appropriatezza: un?analisi sperimentale," MECOSAN, FrancoAngeli Editore, vol. 2017(101), pages 51-74.
    6. Stacy‐ann Robinson, 2020. "Climate change adaptation in SIDS: A systematic review of the literature pre and post the IPCC Fifth Assessment Report," Wiley Interdisciplinary Reviews: Climate Change, John Wiley & Sons, vol. 11(4), July.
    7. Manuela Casula & Ilaria Ardoino & Carlotta Franchi, 2023. "Appropriateness of the Prescription and Use of Medicines: An Old Concept but More Relevant than Ever," IJERPH, MDPI, vol. 20(3), pages 1-5, February.
    8. Levaggi, Rosella & Moretto, Michele & Pertile, Paolo, 2014. "Two-part payments for the reimbursement of investments in health technologies," Health Policy, Elsevier, vol. 115(2), pages 230-236.
    9. Sara Mucherino & Manuela Casula & Federica Galimberti & Ilaria Guarino & Elena Olmastroni & Elena Tragni & Valentina Orlando & Enrica Menditto & on behalf of the EDU.RE.DRUG Group, 2022. "The Effectiveness of Interventions to Evaluate and Reduce Healthcare Costs of Potentially Inappropriate Prescriptions among the Older Adults: A Systematic Review," IJERPH, MDPI, vol. 19(11), pages 1-19, May.

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