Reducing Low-Value Health Care
Authors: Jodi B. Segal
Journal: Annals of Internal Medicine (2024)

Editorials6 February 2024Reducing Low-Value Health CareJodi B. Segal, MD, MPHJodi B. Segal, MD, MPHJohns Hopkins University; Baltimore, MarylandAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M24-3501 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The overuse of some medical services remains a chronic problem in the United States (1). Overuse of health care, or the provision of low- or no-value services, contributes to high costs (2). More importantly, these wasteful services are physically, psychologically, and financially harmful to patients. More than a decade ago, the American Board of Internal Medicine (ABIM) Foundation launched Choosing Wisely to draw attention to low-value practices (3). This campaign aimed to spark conversations between clinicians and patients about health care services that specialty societies identified as being of low value to patients. This includes services that are harmful and ...References1. Brownlee S, Chalkidou K, Doust J, et al. Evidence for overuse of medical services around the world. Lancet. 2017;390:156-168. [PMID: 28077234] doi:10.1016/S0140-6736(16)32585-5 CrossrefMedlineGoogle Scholar2. Morgan DJ, Leppin AL, Smith CD, et al. A practical framework for understanding and reducing medical overuse: conceptualizing overuse through the patient-clinician interaction. J Hosp Med. 2017;12:346-351. [PMID: 28459906] doi:10.12788/jhm.2738 CrossrefMedlineGoogle Scholar3. Colla CH, Morden NE, Sequist TD, et al. Choosing Wisely: prevalence and correlates of low-value health care services in the United States. J Gen Intern Med. 2015;30:221-228. [PMID: 25373832] doi:10.1007/s11606-014-3070-z CrossrefMedlineGoogle Scholar4. Segal JB, Sen AP, Glanzberg-Krainin E, et al. Factors associated with overuse of health care within US health systems: a cross-sectional analysis of Medicare beneficiaries from 2016 to 2018. JAMA Health Forum. 2022;3:e214543. [PMID: 35977230] doi:10.1001/jamahealthforum.2021.4543 CrossrefMedlineGoogle Scholar5. Persell SD, Petito LC, Lee JY, et al. Reducing care overuse in older patients using professional norms and accountability: a cluster randomized controlled trial. Ann Intern Med. 6 February 2024. [Epub ahead of print]. doi:10.7326/M23-2183 LinkGoogle Scholar6. Brown T, Rowe TA, Lee JY, et al. Design of Behavioral Economic Applications to Geriatrics Leveraging Electronic Health Records (BEAGLE): a pragmatic cluster randomized controlled trial. Contemp Clin Trials. 2022;112:106649. [PMID: 34896294] doi:10.1016/j.cct.2021.106649 CrossrefMedlineGoogle Scholar7. American Board of Internal Medicine. Building Trust initiative. Accessed at https://buildingtrust.org on 27 December 2023 Google Scholar8. Giddens A. The Constitution of Society: Outline of the Theory of Structuration. 1st ed. University of California Press; 1984. Google Scholar9. Backholer K, Beauchamp A, Ball K, et al. A framework for evaluating the impact of obesity prevention strategies on socioeconomic inequalities in weight. Am J Public Health. 2014;104:e43-e50. [PMID: 25121810] doi:10.2105/AJPH.2014.302066 CrossrefMedlineGoogle Scholar10. Rütten A, Gelius P. The interplay of structure and agency in health promotion: integrating a concept of structural change and the policy dimension into a multi-level model and applying it to health promotion principles and practice. Soc Sci Med. 2011;73:953-959. [PMID: 21849229] doi:10.1016/j.socscimed.2011.07.010 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Jodi B. Segal, MD, MPHAffiliations: Johns Hopkins University; Baltimore, MarylandDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M24-3501.Corresponding Author: Jodi B. Segal, MD, MPH, Johns Hopkins University, 624 North Broadway, Room 644, Baltimore, MD 21205; e-mail, jsegal@jhmi.edu.This article was published at Annals.org on 6 February 2024. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoReducing Care Overuse in Older Patients Using Professional Norms and Accountability Stephen D. Persell , Lucia C. Petito , Ji Young Lee , Daniella Meeker , Jason N. Doctor , Noah J. Goldstein , Craig R. Fox , Theresa A. Rowe , Jeffrey A. Linder , Ryan Chmiel , Yaw Amofa Peprah , and Tiffany Brown Metrics Latest Keywords Clinical decision support systems Health care quality ePublished: 6 February 2024 Copyright & PermissionsCopyright © 2024 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...