6 notes on how overuse of services may increase cost of US healthcare

Ted Melnick, MD, MHS, assistant professor of emergency medicine at Yale University School of Medicine in New Haven, Conn., lead a team of researchers examining issues of overuse and how this concept influences increasing healthcare costs, according to a statement.

Here are six things to know:

1. Dr. Melnick and colleagues conducted an analysis of CAT scans in patients with minor head injuries.

2. Using previously published data, researchers identified a "testing threshold," wherein the risks and benefits of testing, therapy and missed diagnosis are equal, for ordering CAT scans of minor head injuries.

3. Researchers calculating this threshold by considering the test's effectiveness alone, and by considering its effectiveness in combination with cost. They then compared the two thresholds to the standard of care for minor head injuries.

4. Based on the test's effectiveness, the study suggests the standard of care may not detect all patients for whom the benefits of CAT scans outweigh potential harm.

5. However, when cost was introduced, the data supports the standard of care.

6. Dr. Melnick said that if healthcare professionals never considered cost, the scans should be administered to everyone, but that standard would be costly without a clear benefit, and would counter previous research suggesting which patients should not receive scans.

"We believe these findings could spark a public dialogue about the exponentially increasing costs generated as expensive testing is used on increasingly larger groups of patients at low risk of serious outcomes," said Dr. Melnick. "We conclude that the concept of overuse should be redefined to include the provision of medical services with no benefits or for which harms, including cost, outweigh benefits."

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