Study Examines Research On Overuse Of Health Care Services

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Main Category: Public Health
Article Date: 26 Jan 2012 - 5:00 PST

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An article, which is part of the JAMA/Archives journals 'Less is More' series that is published in the January 23 issue of Archives of Internal Medicine reveals that in the U.S. overusing the health care services appears to be an understudied problem given that research literature is limited to only a few services and rates of overuse vary widely.

Background information in the article states that overuse of medical services, as in those services that provide no benefit or where the benefits are outweighed by harm, tend to contribute to high health care costs. According to some estimates, as much as 30% of U.S. health care spending is due to overuse.

The authors say:

"An understanding of the prevalence of overuse of health care services across the U.S. health system is needed to improve health care quality and eliminate waste."

Deborah Korenstein, M.D., of the Mount Sinai School of Medicine in New York and her team reviewed medical literature on studies regarding overuse of therapeutic procedures, diagnostic tests and medications in the U.S., and found 172 eligible articles of which 53 were on therapeutic procedures, whilst 38 concentrated on diagnostic tests, and 81 were on medications.

Most of the studies focused on four interventions, namely antibiotics for upper respiratory tract infections (URI) and three studies on cardiovascular procedures. According to the researchers rates of overuse varied amongst studies and services studied.

According to the researchers some overuse has declined over time. This includes overuse of inappropriate carotid endarterectomy (CEA), which is a procedure that removes carotid artery plaque. They also observed that inappropriate antibiotic use for viral URI commonly persisted in spite of globally accepted guidelines and other interventions, yet they note that it seems to have reduced over time.

They highlight however, that the limited literature on overuse is understandable given the challenges of developing standards to measure overuse. They conclude:

"Expanding the evidence base and establishing appropriateness criteria for a broader range of services could help target and eliminate overuse in health care services, which could reduce health care spending without adversely affecting the health of the public."

Written by Petra Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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