The state of overuse measurement: A critical review

Kitty S. Chan, Eva Chang, Najlla Nassery, Hsien-Yen Chang, Jodi Segal

Research output: Contribution to journalArticle

Abstract

Health care overuse contributes to unnecessary expenditures and patient exposure to harm. Understanding and addressing this problem requires a comprehensive set of valid metrics. This article describes and critiques the current state of overuse measurement through a review of the published and gray literature, measures clearinghouses and ongoing work by major measure developers. Our review identified 37 fully specified measures and 123 measurement development opportunities. Many services were considered overuse due to the extension of diagnostic or screening services to low-risk populations. There were more diagnostic or therapeutic overuse measures than for screening or monitoring/surveillance. Imaging services is a major focus of current measures, but opportunities exist to expand overuse measurement in medication, laboratory services. Future development of overuse measures would benefit from new empirical research and clinical guidelines focused on identifying indications or populations for which there is likely to be no or low benefit.

Original languageEnglish (US)
Pages (from-to)473-496
Number of pages24
JournalMedical Care Research and Review
Volume70
Issue number5
DOIs
StatePublished - Oct 2013

Fingerprint

Empirical Research
Health Expenditures
Population
Guidelines
Delivery of Health Care
Therapeutics

Keywords

  • health care costs
  • health care overuse
  • inappropriate care
  • performance measurement
  • quality measurement

ASJC Scopus subject areas

  • Health Policy

Cite this

The state of overuse measurement : A critical review. / Chan, Kitty S.; Chang, Eva; Nassery, Najlla; Chang, Hsien-Yen; Segal, Jodi.

In: Medical Care Research and Review, Vol. 70, No. 5, 10.2013, p. 473-496.

Research output: Contribution to journalArticle

@article{380cabb084a34897bf03ec134616c91d,
title = "The state of overuse measurement: A critical review",
abstract = "Health care overuse contributes to unnecessary expenditures and patient exposure to harm. Understanding and addressing this problem requires a comprehensive set of valid metrics. This article describes and critiques the current state of overuse measurement through a review of the published and gray literature, measures clearinghouses and ongoing work by major measure developers. Our review identified 37 fully specified measures and 123 measurement development opportunities. Many services were considered overuse due to the extension of diagnostic or screening services to low-risk populations. There were more diagnostic or therapeutic overuse measures than for screening or monitoring/surveillance. Imaging services is a major focus of current measures, but opportunities exist to expand overuse measurement in medication, laboratory services. Future development of overuse measures would benefit from new empirical research and clinical guidelines focused on identifying indications or populations for which there is likely to be no or low benefit.",
keywords = "health care costs, health care overuse, inappropriate care, performance measurement, quality measurement",
author = "Chan, {Kitty S.} and Eva Chang and Najlla Nassery and Hsien-Yen Chang and Jodi Segal",
year = "2013",
month = "10",
doi = "10.1177/1077558713492202",
language = "English (US)",
volume = "70",
pages = "473--496",
journal = "Medical Care Research and Review",
issn = "1077-5587",
publisher = "SAGE Publications Inc.",
number = "5",

}

TY - JOUR

T1 - The state of overuse measurement

T2 - A critical review

AU - Chan, Kitty S.

AU - Chang, Eva

AU - Nassery, Najlla

AU - Chang, Hsien-Yen

AU - Segal, Jodi

PY - 2013/10

Y1 - 2013/10

N2 - Health care overuse contributes to unnecessary expenditures and patient exposure to harm. Understanding and addressing this problem requires a comprehensive set of valid metrics. This article describes and critiques the current state of overuse measurement through a review of the published and gray literature, measures clearinghouses and ongoing work by major measure developers. Our review identified 37 fully specified measures and 123 measurement development opportunities. Many services were considered overuse due to the extension of diagnostic or screening services to low-risk populations. There were more diagnostic or therapeutic overuse measures than for screening or monitoring/surveillance. Imaging services is a major focus of current measures, but opportunities exist to expand overuse measurement in medication, laboratory services. Future development of overuse measures would benefit from new empirical research and clinical guidelines focused on identifying indications or populations for which there is likely to be no or low benefit.

AB - Health care overuse contributes to unnecessary expenditures and patient exposure to harm. Understanding and addressing this problem requires a comprehensive set of valid metrics. This article describes and critiques the current state of overuse measurement through a review of the published and gray literature, measures clearinghouses and ongoing work by major measure developers. Our review identified 37 fully specified measures and 123 measurement development opportunities. Many services were considered overuse due to the extension of diagnostic or screening services to low-risk populations. There were more diagnostic or therapeutic overuse measures than for screening or monitoring/surveillance. Imaging services is a major focus of current measures, but opportunities exist to expand overuse measurement in medication, laboratory services. Future development of overuse measures would benefit from new empirical research and clinical guidelines focused on identifying indications or populations for which there is likely to be no or low benefit.

KW - health care costs

KW - health care overuse

KW - inappropriate care

KW - performance measurement

KW - quality measurement

UR - http://www.scopus.com/inward/record.url?scp=84885099507&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84885099507&partnerID=8YFLogxK

U2 - 10.1177/1077558713492202

DO - 10.1177/1077558713492202

M3 - Article

C2 - 23804290

AN - SCOPUS:84885099507

VL - 70

SP - 473

EP - 496

JO - Medical Care Research and Review

JF - Medical Care Research and Review

SN - 1077-5587

IS - 5

ER -