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Lancet. 2017 Jul 8;390(10090):156-168. doi: 10.1016/S0140-6736(16)32585-5. Epub 2017 Jan 9.

Evidence for overuse of medical services around the world.

Author information

1
Lown Institute, Brookline, MA, USA; Department of Health Policy, Harvard T.H. Chan School of Public Health, Cambridge, MA, USA. Electronic address: sbrownlee@lownistitute.org.
2
Institute for Global Health Innovation, Imperial College, London, UK.
3
Center for Research in Evidence-Based Practice, Bond University, Gold Coast, QLD, Australia.
4
Lown Institute, Brookline, MA, USA; Menzies Centre for Health Policy, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
5
Royal College of General Practitioners, London, UK.
6
The World Bank, Phnom Penh, Cambodia.
7
Lown Institute, Brookline, MA, USA.
8
LSE Health, London School of Economics and Political Science, London, UK.
9
Menzies Centre for Health Policy, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
10
Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Abstract

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.

PMID:
28077234
PMCID:
PMC5708862
DOI:
10.1016/S0140-6736(16)32585-5
[Indexed for MEDLINE]
Free PMC Article

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