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

BMJ Open. 2023 Jun 16;13(6):e071489. doi: 10.1136/bmjopen-2022-071489.

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.

Keywords: Musculoskeletal disorders; ORTHOPAEDIC & TRAUMA SURGERY; PRIMARY CARE; Quality in health care.

Publication types

  • Review

MeSH terms

  • Australia
  • Consensus
  • Humans
  • Musculoskeletal Diseases* / therapy
  • New South Wales
  • Physical Therapists*