Race and ethnicity do not correlate with healthcare overuse, but a large percentage of overuse is concentrated among white patients, according to a new study published in Milbank Memorial Quarterly.
Prior research on overuse has largely focused on geographic, clinical and payer-related factors rather than sociodemographic characteristics. Researchers, led by Nancy Kressin, Ph.D., director of the Healthcare Disparities Research Program in the Department of Medicine at Boston University School of Medicine, analyzed 59 studies on racial and ethnic disparities in healthcare overuse; of the research studied, 43 percent indicated a higher tendency toward overuse among white patients, but a similar proportion--45 percent--found no significant variation in overuse levels across racial and ethnic groups. Only 12 percent of the research indicated more overuse among racial and ethnic minorities than among white patients.
"We found no clear patterns regarding race and overuse by clinical area, type of treatment, category of findings, or the study's risk of bias," Kressin said in an announcement about the study findings, "although the quality of data was markedly poorer in those studies finding no race differences, and poorer-quality data analyses were most often evident in studies finding more overuse among minorities relative to whites."
There were several major obstacles to more definitive analysis, according to Kressin and her team, such as the general low quality of existing research and difficulty identifying studies on the topic even as concerns grow about disparities within healthcare. The lack of established subject terms on overuse and inappropriate care in PubMed, the search engine researchers used to access the study, was also a major obstacle, according to Kressin.
The study comes in the wake of a February study that found that patients are not the driving force behind care overuse and unnecessary care. Patient requests for such care occurred only 1 percent of the time, indicating poor communication skills among providers may actually be responsible, FiercePracticeManagement previously reported.