low-value care

Low-value care in Australian public hospitals: prevalence and trends over time

Objective To examine 27 low-value procedures, as defined by international recommendations, in New South Wales public hospitals. Design Analysis of admitted patient data for financial years 2010–2011 to 2016–2017. Main outcome measures Number and …

Measuring 21 low-value hospital procedures: claims analysis of Australian private health insurance data (2010–2014)

Objective To examine the prevalence, costs and trends (2010–2014) for 21 low-value inpatient procedures in a privately insured Australian patient cohort. Design We developed indicators for 21 low-value procedures from evidence-based lists such as …

Developing indicators for measuring low-value care: mapping Choosing Wisely recommendations to hospital data

Objective: Low-value health care refers to interventions where the risk of harm or costs exceeds the likely benefit for a patient. We aimed to develop indicators of low-value care, based on selected Choosing Wisely (CW) recommendations, applicable …

A methodological protocol for selecting and quantifying low-value prescribing practices in routinely collected data: an Australian case study

Background Growing imperatives for safety, quality and responsible resource allocation have prompted renewed efforts to identify and quantify harmful or wasteful (low-value) medical practices such as test ordering, procedures and prescribing. …

Quantifying low-value care: a patient-centric versus service-centric lens

Low-value healthcare has been defined as care that is inappropriate for a specific clinical indication, inappropriate for a clinical indication in a specific population or an excessive frequency of services relative to expected benefit.1 Quantifying …

Evidence for overuse of medical services around the world

Overuse, which is defined as the provision of medical services that are more likely to cause harm than good, is a pervasive problem. Direct measurement of overuse through documentation of delivery of inappropriate services is challenging given the difficulty of defining appropriate care for patients with individual preferences and needs; overuse can also be measured indirectly through examination of unwarranted geographical variations in prevalence of procedures and care intensity. Despite the challenges, the high prevalence of overuse is well documented in high-income countries across a wide range of services and is increasingly recognised in low-income countries. Overuse of unneeded services can harm patients physically and psychologically, and can harm health systems by wasting resources and deflecting investments in both public health and social spending, which is known to contribute to health. Although harms from overuse have not been well quantified and trends have not been well described, overuse is likely to be increasing worldwide.