Table 1 Definition and description of selected 24 healthcare services
Category | Healthcare service | Service description and frequency | Study population | Recommendation |
|---|---|---|---|---|
Screening | Colon cancer screening | Colonoscopy/ year | Anyone 50–69 years old | Colonoscopy should be done every 10 years for people 50–69 years old. |
Breast cancer screening | Mammography/ year | 50–74 years old women | Mammography should be done every 2 years for 50–74 years old women. | |
Prostate cancer screening | Prostate-specific antigen (PSA) testing/ year | 50–70 years old men | Routine prostate cancer screening with PSA testing is not recommended. | |
Osteoporosis screening | Dual-energy x-ray absorptiometry (DXA)/ year | People over 60 and with risk factorsa of spontaneous fractures | DXA densitometry is recommended for patients with spontaneous fractures or increased risk of them. | |
Diagnosis | DM: HbA1c test | Glycated hemoglobin (HbA1c) test twice/ year | Adult drug-treated diabetes patients | HbA1c test should be done for diabetes patients at least twice a year. |
DM: kidney exam | Albuminuria and serum creatinine tests/ year | Adult drug-treated diabetes patients | Albuminuria and serum creatinine tests should be done for diabetes patients at least once a year. | |
DM: LDL test | Low-density lipoprotein (LDL) test/ year | Adult drug-treated diabetes patients under 75 years old | LDL test should be done for diabetes patients at least once a year. | |
DM: eye check | Ophthalmologist visit/ year | Adult drug-treated diabetes patients | Eye exam should be performed for diabetes patients at least once a year. | |
TSH | Thyroid stimulating hormone (TSH) test without T3 and T4 tests on the same day | Adults without thyroid disease and receiving TSH test | TSH should be measured as an initial screening test for hypo/hyperthyroidism, while T3 and T4 test should follow if TSH is abnormal. | |
POCR | Outpatient preoperative chest radiography (POCR) up to 2 months before surgery | Adult patients with inpatient surgical procedures | Routine chest radiography is not recommended before surgery. | |
Primary prevention | Influenza vaccination | Influenza outpatient vaccination/ year | People over 65 years old or with a specified chronic conditionb | People over 65 years old and patients with chronic conditions, specified by Federal Office of Public Health, should be vaccinated against influenza every year. |
Treatment | BZD | Cumulative prescription of benzodiazepines (BZD) for > 8 weeks/ year | Anyone over 65 years old | Long-term use of benzodiazepines and other hypnotics is discouraged for old patients. |
PPI | Cumulative prescription of proton pump inhibitors (PPI) or H2 histamine receptor antagonists (H2) for > 8 weeks/ year | Adults receiving PPI or H2 drugs | PPI should not be used at maximal dose for prolonged periods of time. | |
Outpatient procedures | Specified surgical proceduresc done in the outpatient setting | Adult patients with specified surgical procedures (either as in- or outpatient) | If none of the special conditions apply, certain surgical procedures should be done in the outpatient setting. | |
C-section | Cesarean section (C-section) | Women giving birth without absolute indicationsd for C-section | C-section should not be performed unless absolute or relative indications are present. | |
Secondary prevention | AMI: aspirin | Aspirin prescription within 2 weeks after acute myocardial infarction (AMI) | Adult patients with AMI | All myocardial infarction patients should take aspirin long-term. |
AMI: statin | High-dose statin prescription within 2 weeks after AMI | Adult patients with AMI | All myocardial infarction patients should get statins long-term. | |
AMI: beta-blocker | Beta-blocker prescription within 2 weeks after AMI | Adult patients with AMI | All myocardial infarction patients with heart failure or impaired function should get beta-blockers long-term. | |
AMI: ACE/ARB | Angiotensin converting enzyme (ACE) or angiotensin receptor blocker (ARB) antihypertensive medication prescription within 2 weeks after AMI | Adult patients with AMI | All myocardial infarction patients with heart failure or impaired function should get ACE or ARB antihypertensive medication long-term. | |
AMI: P2Y | P2Y antiplatelet druge prescription within 2 weeks after AMI | Adult patients with AMI | All myocardial infarction patients should get P2Y antiplatelet drugs for at least 1–12 months according to the bleeding risk profile and AMI treatment. | |
PPI with NSAID | PPI prescription within 1 month or up to 3 months before initial long-term nonsteroidal anti-inflammatory drug (NSAID) prescription | Adult patients with a cumulative NSAID prescription of > 8 weeks at maximal dose | Patients taking long-term NSAID and with risk factors for gastric ulcerf should also take PPI. | |
PAD: statin | Prescription of statins within 3 months after peripheral artery disease (PAD) identification | Adult patients undergoing diagnostic or treatment procedures for PAD | Statins are recommended for all patients with PAD. | |
Afib: anticoagulation | Oral anticoagulation prescription within 2 weeks after atrial fibrillation (Afib) identification | Adult patients with atrial fibrillation diagnosis and additional risk factorsg | All patients with atrial fibrillation should be prescribed oral anticoagulation for embolic events prevention according to the CHA2DS2-VASc score. | |
GKK | Glucocorticoid (GKK) prescription within 1 month or up to 3 months before disease-modifying antirheumatic drug (DMARD) prescription | Adult patients with a new prescription of DMARD by a rheumatologist | Short-term glucocorticoids should be taken with newly prescribed DMARD. |