Under ruse
"In many countries, evidence exists for the overuse of aggressive care for dying patients and simultaneous underuse of appropriate palliative care," the researchers note, adding, "Despite evidence that the majority of people around the world would prefer to die at home, about half die in hospital worldwide, with considerable variation among countries." Futile intravenous nutrition and aggressive, highly unlikely to work chemotherapies that actually cause death quicker, are a couple of the reported efforts often given to terminal patients. "But on a personal level, who wants to be the person who should have had a colonoscopy more frequently and didn't get it?"Įnd-of-life care is a prime depiction of how overuse of one type of service can cause underuse of a far more appropriate option, like hospice. "If you look at this from a big public health perspective it (too many screenings/tests) doesn't have the payoff," says Philadelphia-based medical malpractice attorney Max Kennerly in a phone interview. alone reporting an overuse rate of 60 percent for the latter. Each of these areas are vital, even life-saving when indicated by patient history, symptoms and other specific considerations, but when used willy-nilly the burden is great for both patients (many of whom still lack adequate insurance) and the healthcare system.Īmong these, medication overuse is one of the most publicly acknowledged examples, because when prescribed unnecessarily the threat of microbial resistance increases, putting the patient and general population at risk.Įxpensive and sometimes traumatic diagnostic tests, like endoscopy and colonoscopy, are also commonly overused, with the U.S.
The researchers outlined a number of areas where overuse is commonly reported: medications, screening tests, diagnostic testing, therapeutic procedures (surgery and other invasive procedures), site of care delivery (staying in a hospital when a less aggressive site would suffice) and end-of-life care. "Overuse of unneeded services can harm patients physically and psychologically, and can harm health systems by wasting resources and deflecting investments in both public health and social spending, which is known to contribute to health," the researchers explain in the first paper in the series.
Medical services that are overused are considered more likely to cause harm than good if used inappropriately.