In search of professional consensus in defining and reducing low-value care.
Care that confers no benefit or benefit that is disproportionately low compared with its cost is of low value and potentially wastes limited resources. It has been claimed that low-value care consumes at least 20% of health care resources in the United States - the comparable figure in Australia is unknown but there is emerging evidence of overuse of diagnostic tests and therapeutic procedures. Very few clinical interventions are of no value in every clinical circumstance, and efforts to label interventions as being so will meet with professional resistance. In the context of complex and highly individualised clinical decisions, nuanced clinical judgements of experienced and well informed clinicians are likely to outperform any service-level measurement and incentive program aimed at recognising and reducing low-value care. Public policy interventions should focus on supporting clinician-led efforts to seek professional consensus on what constitutes low-value care and the best means for reducing it.
Princess Alexandra Hospital, Brisbane, QLD ian.scott@health.qld.gov.au.
Ian A
IA
Scott
Grattan Institute, Melbourne, VIC.
Stephen J
SJ
Duckett
D001315:Australia; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration / Q000592:standards; D017048:Health Care Costs; D006801:Humans; D011787:Quality of Health Care / Q000191:economics / Q000458:organization & administration / Q000592:standards; D019564:Unnecessary Procedures / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data