Overuse of Health Care Services Understudied

Research limited primarily to unnecessary antibiotic use and a few cardiovascular procedures

WEDNESDAY, Jan. 25 (HealthDay News) -- Overuse of health care services in the United States is an understudied problem, with the majority of research limited to a few interventions, according to a review published in the Jan. 23 issue of the Archives of Internal Medicine.

Deborah Korenstein, M.D., of the Mount Sinai School of Medicine in New York City, and colleagues conducted a literature review of studies, published from 1978 to 2009, measuring rates of overuse of procedures, tests, and medications in the United States.

The researchers found 172 articles measuring overuse: 53 focused on therapeutic procedures, 38 on diagnostic tests, and 81 on medication use. There were 18 unique therapeutic procedures and 24 diagnostic services, including 10 preventive services, included in the analyses. Antibiotics for upper respiratory tract infections (URIs) were most frequently studied (59 studies); other commonly studied services included coronary angiography (17 studies), carotid endarterectomy (13 studies), and coronary artery bypass grafting (10 studies). Over time, there was a decline seen in the overuse of carotid endarterectomy and antibiotics for URIs.

"The robust evidence about overuse in the United States is limited to a few services. Reducing inappropriate care in the U.S. health care system likely requires a more substantial investment in overuse research," the authors write.

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