Study examines overuse of ambulatory health care services in US
An analysis of nationally representative survey data found significant improvement in the delivery of underused care, but more limited changes in the reduction of inappropriate care in ambulatory health care settings between 1998 and 2009, according to a report published Online First by Archives of Internal Medicine.
"Given the rising costs of health care, policymakers are increasingly interested in identifying the inefficiencies in our health care system," the authors write as background. "The objective of this study was to determine whether the overuse and misuse of health care services in the ambulatory setting has decreased in the past decade."
Minal S. Kale, M.D., with Mt. Sinai School of Medicine, New York, and colleagues conducted an analysis using data from the 1998, 1999, 2008 and 2009 National Ambulatory Medical Care Survey (NAMCS) and the outpatient department component of the National Hospital Ambulatory Medical Care Survey (NHAMCS), both of which are nationally representative surveys conducted annually by the Centers for Disease Control and Prevention's National Center for Health Statistics.
The study sample included 79,083 and 102,980 unweighted visits by adult patients at least 18 years of age in 1998 to 1999, and 2008 to 2009, respectively. Compared with visits made in 1998-1999, visits in 2008-2009 were by slightly older patients (average age 54.2 years vs. 50.9 years), and more patients were insured by Medicare.
The authors found a statistically significant improvement in six of nine underuse quality indicators, including improvement in use of antithrombotic therapy for atrial fibrillation; use of aspirin, β-blockers, and statins in coronary artery disease; use of β-blockers in congestive heart failure; and the use of statins in diabetes mellitus.
The authors also observed improvement in two of 11 overuse quality indicators, which included a statistically significant decrease in cervical cancer screening among women older than 65 years, as well as a reduction in the overuse of antibiotics for asthma exacerbations. However, there was an increase in one overuse indicator, prostate cancer screening in men older than 74 years. The authors observed no changes in the other eight quality indicators during the study period.
"In our examination of ambulatory care in the United States, we found an improvement in most of the underuse measures but limited changes in the delivery of inappropriate care," the authors conclude. "Developing clinical practice guidelines that define when care should not be delivered and performance measures to address inappropriate care are critical steps to advance the mission of increasing the value and efficiency of health care delivery."
More information: Arch Intern Med. Published online December 24, 2012. doi:10.1001/2013.jamainternmed.1022
Journal reference:
JAMA Internal Medicine
Provided by
JAMA and Archives Journals
-
Study examines research on overuse of health care services
Jan 23, 2012 |
not rated yet |
0
-
Antibiotics often the wrong prescription for pediatric asthma
Jun 01, 2011 |
not rated yet |
0
-
Costs of neck and back conditions increasing in U.S.
Sep 11, 2012 |
not rated yet |
0
-
Researchers investigate differences in quality of care delivered by US resident and staff physicians
Sep 21, 2010 |
not rated yet |
0
-
Young adults visit doctors least at an age when risky behavior peaks
Sep 25, 2009 |
not rated yet |
0
-
Motion perception revisited: High Phi effect challenges established motion perception assumptions
Apr 23, 2013 |
3 / 5 (2) |
2
-
Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update)
Apr 02, 2013 |
4.5 / 5 (11) |
5
-
The visual system as economist: Neural resource allocation in visual adaptation
Mar 30, 2013 |
5 / 5 (2) |
9
-
Separate lives: Neuronal and organismal lifespans decoupled
Mar 27, 2013 |
4.9 / 5 (8) |
0
-
Sizing things up: The evolutionary neurobiology of scale invariance
Feb 28, 2013 |
4.8 / 5 (10) |
14
-
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011
- More from Physics Forums - Independent Research
More news stories
Seniors more likely to crash when driving with pet, study finds
(HealthDay)—Animals make great companions for senior citizens, but elderly people who always drive with a pet in the car are far more likely to crash than those who never drive with a pet, researchers have ...
Health
1 hour ago |
not rated yet |
0
Driving and hands-free talking lead to spike in errors, study shows
Talking on a hands-free device while behind the wheel can lead to a sharp increase in errors that could imperil other drivers on the road, according to new research from the University of Alberta.
Health
May 24, 2013 |
not rated yet |
1
About one in four uninsured could be excluded from ACA
(HealthDay)—More than one in four of those eligible for new premium assistance tax credits under the Affordable Care Act (ACA) do not have a checking account and will not be able to receive premiums from ...
Health
May 24, 2013 |
not rated yet |
0
Audiologists recommend smart phone apps to monitor noise levels
After studying noise in one French Quarter neighborhood of New Orleans to determine whether or not noise levels exceeded municipal ordinances, Annette Hurley, PhD, Assistant Professor of Audiology at LSU Health Sciences Center ...
Health
May 24, 2013 |
not rated yet |
0
Young children who miss well-child visits are more likely to be hospitalized
Young children who missed more than half of recommended well-child visits had up to twice the risk of hospitalization compared to children who attended most of their visits, according to a study published today in the American Jo ...
Health
May 24, 2013 |
not rated yet |
0
First drug to improve heart failure mortality in over a decade
Coenzyme Q10 decreases all cause mortality by half, according to the results of a multicentre randomised double blind trial presented today at Heart Failure 2013 congress. It is the first drug to improve heart failure mortality ...
Heart failure accelerates male 'menopause'
Heart failure accelerates the aging process and brings on early andropausal syndrome (AS), according to research presented today at the Heart Failure Congress 2013. AS, also referred to as male 'menopause', was four times ...
Death highest in heart failure patients admitted in January, on Friday, and overnight
Mortality and length of stay are highest in heart failure patients admitted in January, on Friday, and overnight, according to research presented today at the Heart Failure Congress 2013. The analysis of nearly 1 million ...
Feds fight morning-after pill age ruling in NY
(AP)—Department of Justice lawyers have again asked a federal appeals court in New York to delay lifting age restrictions and prescription requirements on an emergency contraceptive popularly known as the morning-after ...
New immune system discovered
(Medical Xpress)—A research team, led by Jeremy Barr, a biology post-doctoral fellow, unveils a new immune system that protects humans and animals from infection.
Brain can be trained in compassion, study shows
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.