Which health systems are providing low value care?

That is the question posted by Ganguli et al. (2021). The define low value care as one of 41 specific services. They then use data across 556 health systems serving more than 11m beneficiaries to answer this question.

Which types of low value care are most commonly used?

The most common low-value services were preoperative laboratory testing (mean [SD] rate, 28% [4%] of eligible beneficiaries), prostate-specific antigen testing in men older than 70 years (mean [SD] rate, 27% [8%]), and use of antipsychotic medications in patients with dementia (mean [SD] rate, 24% [8%]).

Health system characteristics associated with increased rates of low value care include:

  • Fewer primary care physicians,
  • No major teaching hospital
  • A larger share of minority (i.e., non-White) patients
  • Located in South or West
  • Serving areas with more health care spending

Quality of care includes both positive and negative actions; that is performing high-quality, high-value services and avoiding low-quality, low-value services. While this study only examines one side of this coin, it does show that there is still room to improve to reduce the use of low-value services.

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