Family medicine

The study find that the Health care institutions and providers face mounting pressure to wring more value out of every dollar spent on caring for their patients. Therefore A new review shows that most efforts to decrease low-value care have based their measurement of success on how much they reduced the overall use of certain tests and treatments. Because Far fewer look at whether these efforts actually ensure that patients got more appropriate care and avoided unintend negative consequences.

Decrease low-value care

The review, published in the Journal of General Internal Medicine; looks at 117 different efforts aimed at reducing low-value care and how they measured the effects of these efforts. “Low-value” can mean many things, including care that doesn’t benefit patients and could even harm them; wastes limited health care resources or leads to unnecessary costs.

Hundreds of studies over the past two decades have revealed many services that lack value for all patients; or just certain patients. Patients and clinicians now have easy-to-follow guidance on what those are; thanks to the Choosing Wisely campaign from the the American Board of Internal Medicine Foundation. The new review focuses on what happens when teams act on this evidence and guidance; and researchers try to study the effects.

Patients and clinicians

The bottom line? Those trying to reduce low-value care should take a bigger-picture view. The authors; led by health care researchers from the University of Michigan Institute for Healthcare Policy and Innovation, VA Ann Arbor Center for Clinical Management Research and the University of Toronto; therefore performed the review at the request of Academy Health; a non-profit professional society focused on improving health and health care by moving researchers’ evidence into action. The study is find by the Patient-Centered Outcomes Research Institute.

Reducing use of low-value services is important; but in doing so, we need to also make sure we are assessing things that are clinically relevant, like whether appropriate care is being delivered to patients rather than only whether use of a given service is being reduced.” Jennifer Maratt, M.D., clinical lecturer in the U-M Department of Internal Medicine and the VA Ann Arbor Healthcare System who led the study with Sameer Saini, M.D. and Eve Kerr, M.D.

Healthcare Policy and Innovation

The researchers looked at 101 papers published between 2010 to 2016 about specific efforts to reduce low-value care. They also examined 16 studies that are still under way through ClinicalTrials.gov. But In all, 68% of the already-published efforts focused on measuring and changing the use of a particular test or treatment; but only 41% measured an outcome that is, what happened when they changed that use. About half tried to gauge whether a particular test or treatment was appropriate for patients  arguably the most clinically meaningful measure.