Statistics from Altmetric.com
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 the prevalence of low-value healthcare informs clinicians and health policy makers on the use and associations of unwarranted care.2 In this Viewpoint, we clarify the approaches used in the literature for measuring and reporting the level of low-value care in a given population. Categorising low-value service measures depends on the denominator used. Future analyses should consider using all types of measures when possible, or explain why it is not practical or desirable to do so, and at the very least describe for the reader which measure has been used, as this can dramatically impact interpretation of the results.
Low-value care: listed and (variably) measured
Defining, quantifying and reducing low-value healthcare are important co-dependent issues with an increasing focus in the literature.3 4 Lists or guidelines defining low-value services for given patient populations are now mushrooming.5 Choosing Wisely, for example, is a prominent international movement promoting lists of recommendations on low-value services that offer no or very limited benefit to patients under specific circumstances.6 Interventions targeting the reduction of low-value or no-value care offer the dual benefit of improving safety and quality and making inroads into escalating healthcare expenditure.7
Playing catch-up to list generation (particularly outside of the USA) is the measurement movement; work that quantifies the proportion, characteristics and trends in low-value care.3 8 9 It is curious that low-value lists abound, yet the world over we have but a cursory understanding of the scale and scope of low-value care due to the general lack of measurement.3 Not surprisingly then, a growing number of population-based measurement studies are surfacing through the rubric of …
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.