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Unnecessary healthcare

Unnecessary health care overutilization, overuse, or ((overtreatment)) is health care provided with a higher volume or cost than is appropriate.

In the United States overuse accounts for about a third of its health care spending.

An estimated 10 to 34% of all medical care is  considered to be of low value or inappropriate, including 20 to 50% of medical imaging.

Factors that drive overuse include paying health professionals more to do more, defensive medicine to protect against litigiousness, and insulation from price sensitivity in instances where the consumer is not the payer, but insurance pays for them, whether public insurance, private, or both.

 

 

The above factors influence: physicians, patients, pharmaceutical companies, device manufacturers, all with inadequate incentive to restrain health care prices or overuse.

 

 

Overtreatment, in the strict sense, may refer to unnecessary medical interventions, including treatment of a self-limited condition ((overdiagnosis)) or to extensive treatment for a condition that requires only limited treatment.

 

 

Unnecessary healthcare is economically linked to overmedicalization.

 

 

It is known that Medicare enrollees in higher-spending regions receive more care than those in lower-spending regions, but do not have better health outcomes or satisfaction with care.

 

 

Unnecessary healthcare is in contrast to, 

 

parsimonious care, defined as care that utilizing the most efficient means to diagnose and treat a patient.

 

 

Unnecessary healthcare subjects  patients to care that does help them, and is rooted in outmoded habits, supply-driven behaviors, and ignores science.

 

 

In the US, the country which spends the most on health care per person globally, patients have fewer doctor visits and fewer days in hospitals than people in other countries do.

 

 

In the US prices are high, there is more use of some procedures and new drugs than elsewhere, and doctor salaries are double the levels in other countries.

 

 

Estimated that between $.30 and $.40 of every dollar spent on health care is spent on the costs of poor quality,

 

 

Slightly more than a half-trillion dollars a year is wasted on overuse, underuse, misuse, duplication, system failures, unnecessary repetition, poor communication, and inefficiency.

 

 

There  is no apparent health benefit for Medicare recipients from doing more, whether  its hospitalizations, surgical procedures, or consultations within a hospital.

 

 

Up to 30% of Medicare spending could be cut without harming patients.

 

 

Overuse of healthcare puts patients 

 

at risk of complications unnecessarily, with documented harm to patients from overuse of surgeries and other treatments.

 

 

Causes Edit

 

 

Physicians’ decisions are the cause of unnecessary care.

 

 

Physicians act on potential incentives and penalties which can influence their choices.

 

 

When insurance covers expenses and doctors are paid under a fee-for-service (there is no incentive to consider the cost of treatment, contributing  to waste.

 

 

Fee-for-service is a large incentive for overuse.

 

 

To protect themselves from legal prosecution U.S. physicians have an incentive to order clinically unnecessary tests or tests of little potential value.

 

 

Direct-to-consumer advertising encourages patients to ask for drugs, devices, diagnostics, or procedures. 

 

 

Miitigating risk without considering how small or unlikely the potential benefit is

 

 

Attempting to fix an underlying problem, instead of monitoring or using a coping strategy.

 

 

Acting too quickly, when waiting for more information might be wiser.

 

 

Acting without considering the benefits of doing nothing.

 

 

Discounting downsides of diagnostic testing.

 

 

Preferring newer over older treatments without considering the cost of new treatments or the effectiveness of older ones.

 

 

Treating patients with terminal illness to maximize life span over quality of life, without probing a patient’s preferences.

 

 

Overuse of diagnostic imaging is unlikely to improve patient care.

 

 

Overuse of imaging: include- self-referral, patient wishes, inappropriate financially motivated factors, health system factors, industry, media, lack of awareness and defensive medicine.

 

 

Overuse of imaging can lead to a diagnosis of a condition that would have otherwise remained irrelevant.

 

 

The majority of U.S. growth in imaging use comes from self-referring nonradiologists.

 

 

Unnecessary healthcare in pediatrics including overtreatment overmedicalization, and overdiagnosis: use of commercial rehydration solution, antidepressants, and parenteral nutrition; overmedicalization with planned early deliveries, immobilization of ankle injuries, use of hydrolyzed infant formula; and overdiagnosis of hypoxemia among children recovering from bronchiolitis.

 

 

Other examples of unnecessary healthcare include: Hospitalizations

 

for those with chronic conditions who could be treated as outpatients, 

 

surgeries in patients in their last year of life, antibiotic use for viral or self-limiting infections, over opiate prescriptions, blood transfusions, coronary artery stents, screening patients with advanced cancer for other cancers, and annual cervical cancer screening in women with medical histories of normal pap smear and HPV test results.

 

 

 

 

 

 

 

 

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