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Systematic Overuse of Healthcare Services: A Conceptual Model

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  • Najlla Nassery
  • Jodi Segal
  • Eva Chang
  • John Bridges

Abstract

A perfect storm of factors influences the overuse of healthcare services in the USA. Considerable attention has been placed on geographic variation in utilization; however, empiric data has shown that geographic variation in utilization is not associated with overuse. While there has been renewed interest in overuse in recent years, much of the focus has been on the overuse of individual procedures. In this paper we argue that overuse should be thought of as a widespread and pervasive phenomenon that we coin as systematic overuse. While not directly observable (i.e., a latent phenomenon), we suggest that systematic overuse could be identified by tracking a portfolio of overused procedures. Such a portfolio would reflect systematic overuse if it is associated with higher healthcare costs and no health benefit (including worse health outcomes) across a healthcare system. In this report we define and conceptualize systematic overuse and illustrate how it can be identified and validated via a simple empirical example using several Choosing Wisely indicators. The concept of systematic overuse requires further development and empirical verification, and this paper provides an important first step, a conceptual framework, to that end. Copyright Springer International Publishing Switzerland 2015

Suggested Citation

  • Najlla Nassery & Jodi Segal & Eva Chang & John Bridges, 2015. "Systematic Overuse of Healthcare Services: A Conceptual Model," Applied Health Economics and Health Policy, Springer, vol. 13(1), pages 1-6, February.
    • Handle: RePEc:spr:aphecp:v:13:y:2015:i:1:p:1-6
    DOI: 10.1007/s40258-014-0126-5
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    Cited by:

    1. Carine Milcent & Saad Zbiri, 2018. "Prenatal care and socioeconomic status: effect on cesarean delivery," Health Economics Review, Springer, vol. 8(1), pages 1-21, December.
    2. Sungje Moon & Mankyu Choi, 2018. "The Effect of Usual Source of Care on the Association of Annual Healthcare Expenditure with Patients’ Age and Chronic Disease Duration," IJERPH, MDPI, vol. 15(9), pages 1-11, August.
    3. Zhang, Yi & Zhou, Zhongliang & Si, Yafei, 2019. "When more is less: What explains the overuse of health care services in China?," Social Science & Medicine, Elsevier, vol. 232(C), pages 17-24.
    4. Duberstein, Paul R. & Hoerger, Michael & Norton, Sally A. & Mohile, Supriya & Dahlberg, Britt & Hyatt, Erica Goldblatt & Epstein, Ronald M. & Wittink, Marsha N., 2023. "The TRIBE model: How socioemotional processes fuel end-of-life treatment in the United States," Social Science & Medicine, Elsevier, vol. 317(C).

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