Altarum Center for Value in Health Care, Arbor, MI, USA.
Altarum Center for Value in Health Care, Arbor, MI, USA.
Value Health. 2018 Apr;21(4):375-379. doi: 10.1016/j.jval.2017.10.017. Epub 2017 Nov 27.
It has been estimated that more than 30% of health care spending in the United States is wasteful, and that low-value care, which drives up costs unnecessarily while increasing patient risk, is a significant component of wasteful spending.
To address the need for an ability to measure the magnitude of low-value care nationwide, identify the clinical services that are the greatest contributors to waste, and track progress toward eliminating low-value use of these services. Such an ability could provide valuable input to the efforts of policymakers and health systems to improve efficiency.
We reviewed existing methods that could contribute to measuring low-value care and developed an integrated framework that combines multiple methods to comprehensively estimate and track the magnitude and principal sources of clinical waste. We also identified a process and needed research for implementing the framework.
A comprehensive methodology for measuring and tracking low-value care in the United States would provide an important contribution toward reducing waste. Implementation of the framework described in this article appears feasible, and the proposed research program will allow moving incrementally toward full implementation while providing a near-term capability for measuring low-value care that can be enhanced over time.
据估计，美国超过 30%的医疗保健支出是浪费的，而低价值的医疗服务不必要地增加了成本，同时增加了患者的风险，是浪费支出的一个重要组成部分。
为了满足衡量全国范围内低价值医疗服务的规模、确定对浪费贡献最大的临床服务以及跟踪消除这些服务的低价值使用的进展的需求。这种能力可以为政策制定者和卫生系统提高效率的努力提供有价值的投入。
我们回顾了可能有助于衡量低价值医疗服务的现有方法，并开发了一个综合框架，该框架结合了多种方法，全面估计和跟踪临床浪费的规模和主要来源。我们还确定了实施该框架所需的流程和研究。
在美国，衡量和跟踪低价值医疗服务的综合方法将为减少浪费做出重要贡献。本文描述的框架的实施似乎是可行的，而拟议的研究计划将允许逐步全面实施，同时提供一个可随时间推移增强的衡量低价值医疗服务的近期能力。
