High Value Care Assessment

High Value Care (“HVC”) can be defined simply as care that balances the benefits, harms, and costs of tests and treatments. Authors of a recent study wrote “Faculty discussions of HVC during patient care correlated with such knowledge and practice and may represent an opportunity to improve residents’ competency in providing value-based care.”

The American College of Physicians and the Alliance for Academic Internal Medicine designed a survey to gauge U.S. internal medicine residents’ knowledge of, attitudes toward, and self-reported practice of HVC. The survey polled over 18,000 internal medicine residents in the United States. Here are some highlights of the survey’s findings:

88% of internal medicine residents surveyed said they incorporate patient’s values and concerns into clinical decisions

Regarding overuse:

  • 85% of respondents agreed that overuse is driven by defensive medicine
  • 61% stated that overuse is driven by diagnostic uncertainty
  • 55% stated that overuse is driven by patient demand
  • 47% agreed that overuse is driven by inadequate patient follow-up

59% of internal medicine residents surveyed agreed that they reduced healthcare waste within their hospital and/or clinic

46% of internal medicine residents surveyed stated that they incorporate the cost of tests and treatments into clinical decisions

40% of respondents discussed balancing the benefits, harms, and costs of treatments with faculty during patient care at least a few times per week

25% of those surveyed say they know where to find cost estimates for tests and treatments

24% of internal medicine residents surveyed share estimated test and treatment costs with patients

The survey also reported that over two-thirds of respondents declared having adequate knowledge of the benefits and harms of tests and treatments, offering patients alternatives, considering patients’ values and concerns, and avoiding unnecessary care.

The survey can be found here.

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