​​​​​​​Target healthcare overuse, underuse to improve care quality: report

A compass pointing to the word "quality."
Redefining what the "right care" is can reduce healthcare overuse and underuse, according to a new series from The Lancet. Image: Getty/Olivier Le Moal

Both overuse and underuse of medicine are significant burdens on the healthcare industry, and a new series from The Lown Institute in partnership with The Lancet pushed for providers to focus on “right care” to better reach both sets of patients and improve overall quality of care.

The series defines “right care” as “care that weighs up benefits and harms, is patient-centered (taking individual circumstances, values and wishes into account) and is informed by evidence, including cost-effectiveness,” according to the first article (PDF) in the series. To address the care improvements this would require, the series’ authors called for a close examination of the roles of various stakeholders in the health industry and perhaps redefine them to better tackle these issues.

Vikas Saini, M.D., president of the Lown Institute and author of much of the series, said at a launch meeting in London that this is an “ideal” definition and acknowledged that it is “insanely ambitious” program, according (reg. req.) to Medscape Medical News.

Patients that overuse healthcare in the U.S. are likely to have multiple comorbidities, and are common contributors to emergency department overcrowding. Another article (PDF) in the series noted that wealthier nations like the United States are most likely to benefit from reducing super-users, as they are a significant drain on both finances and healthcare resources.

The article noted that healthcare overuse is a significant problem and may require a complex response. Authors suggest that overuse and underuse can be attacked simultaneously as major, related concerns. This will require the healthcare industry globally to invest in nations that may not have the capacity to meet demand while also improving care coordination and quality in regions that have better access.

In a third article, the authors wrote that part of the problem is a significant lack of key data on both issues, and that gathering better research should also be a first step. Addressing both overuse and underuse will also require political leaders to form a united front and continue to support programs that target the social determinants of health, like wellness initiatives.