Choosing Wisely: Prevalence and Correlates of Low-Value Health Care Services in the United States

Journal of General Internal Medicine
November 2014
Colla, C.H., Morden, N.E., Sequist, T.D., Schpero, W.L., and Rosenthal, M.B.

Specialty societies in the United States identified low-value tests and procedures that contribute to waste and poor health care quality via implementation of the American Board of Internal Medicine Foundation’s Choosing Wisely initiative. The researchers used Medicare data from 2006 to 2011, to develop claims-based algorithms and estimate the prevalence of 11 Choosing Wisely low-value services. The researchers used the results of their study to examine the demographic health and health care system correlates of low-value care at a regional level. Their results show that regional characteristics associated with higher use of low-value services included greater overall per capita spending, a higher specialist to primary care ratio, and higher proportion of minority beneficiaries. Their findings suggest that the delivery of wasteful and potentially harmful services may be a fruitful area for further research and policy intervention for hospital referral regions (HRRs) with higher per-capita spending.

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