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Low-Value Clinical Practices: Knowledge and Beliefs of Spanish Surgeons and Anesthetists

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  • Jesús María Aranaz Andrés

    (CIBER Epidemiología y Salud Pública (CIBERESP), Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain)

  • José Lorenzo Valencia-Martín

    (Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain)

  • Jorge Vicente-Guijarro

    (Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, Departamento de Medicina y Especialidades Médicas, Facultad de Medicina, Universidad de Alcalá, IRYCIS, 28034 Madrid, Spain)

  • Cristina Díaz-Agero Pérez

    (Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain)

  • Nieves López-Fresneña

    (Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain)

  • Irene Carrillo

    (Miguel Hernández University of Elche, 03202 Elche, Spain
    Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain)

  • José Joaquín Mira Solves

    (Miguel Hernández University of Elche, 03202 Elche, Spain
    Alicante-Sant Joan Health District, Ministry of Health, 03550 Alicante, Spain
    REDISSEC, Health Services Network Oriented to Chronic Diseases, Spain)

  • SOBRINA Working Group

    (Members are listed at the Acknowledgments.)

Abstract

OBJECTIVES : To know the frequency and causes of low value surgical practices, according to the opinion of surgeons and anesthetists, and to determine their degree of knowledge about the Spanish “Choosing wisely” initiative. METHODS : Cross-sectional observational study, based on a self-administered online questionnaire through an opportunistic sample of 370 surgeons and anesthetists from three Spanish regions, contacted through Scientific Societies. The survey took part between July and December 2017. RESULTS : A patient profile requesting unnecessary practices was identified (female, 51−65 years old and unaffiliated disease). The frequency of requests was weekly or daily for 50.0% of the professionals, of whom 15.1% acknowledged succumbing to these pressures. To dissuade the patient, clinical reasons (47%) were considered the most effective. To increase control and safety in the case was the main reason to indicate them. The greatest responsibility for overuse was attributed to physicians, defensive medicine and mass media. Assessing professionals’ knowledge on unnecessary practices, an average of 5 correct answers out of 7 was obtained. Some 64.1% of the respondents were unaware of the Spanish “Choosing wisely” initiative. CONCLUSION S: Low value surgical practices are perceived as a frequent problem, which requires an approach entailing intervention with patients and the media as well as professionals. Increase awareness on unnecessary surgical practices, and how to avoid them remain essential.

Suggested Citation

  • Jesús María Aranaz Andrés & José Lorenzo Valencia-Martín & Jorge Vicente-Guijarro & Cristina Díaz-Agero Pérez & Nieves López-Fresneña & Irene Carrillo & José Joaquín Mira Solves & SOBRINA Working Grou, 2020. "Low-Value Clinical Practices: Knowledge and Beliefs of Spanish Surgeons and Anesthetists," IJERPH, MDPI, vol. 17(10), pages 1-14, May.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:10:p:3556-:d:360110
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    References listed on IDEAS

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    1. Bernal-Delgado, Enrique & García-Armesto, Sandra & Peiró, Salvador, 2014. "Atlas of Variations in Medical Practice in Spain: The Spanish National Health Service under scrutiny," Health Policy, Elsevier, vol. 114(1), pages 15-30.
    2. He, Alex Jingwei, 2014. "The doctor–patient relationship, defensive medicine and overprescription in Chinese public hospitals: Evidence from a cross-sectional survey in Shenzhen city," Social Science & Medicine, Elsevier, vol. 123(C), pages 64-71.
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    1. Jorge Vicente-Guijarro & José Lorenzo Valencia-Martín & Paloma Moreno-Nunez & Pedro Ruiz-López & José Joaquín Mira-Solves & Jesús María Aranaz-Andrés & SOBRINA Working Group, 2020. "Estimation of the Overuse of Preoperative Chest X-rays According to “Choosing Wisely”, “No Hacer”, and “Essencial” Initiatives: Are They Equally Applicable and Comparable?," IJERPH, MDPI, vol. 17(23), pages 1-18, November.

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