Over- and underuse of medicine, healthcare found in worldwide study

January 9, 2017

Medicine and healthcare services are found to be both over- and underused in countries all over the world, causing avoidable harm to patients and wastage of resources, according to studies conducted by a team of 27 international specialists.

The team of experts found that 57% of patients in China receive inappropriate antibiotics; 16-70% of hysterectomies – a surgical procedure where a woman’s uterus or womb is removed – in the US are inappropriate; while inappropriate total knee replacement rates were 26% in Spain and 34% in the US.

Rates of inappropriate hysterectomies were 20% in Taiwan and 13% in Switzerland, they found.

They also found the simple use of steroids to prevent premature births has lagged for 40 years, while rates of Caesarian section (C-section) deliveries are soaring and often in women who do not need it. The World Health Organization (WHO) estimates that 6.2 million excess C-sections are performed each year – 50% of them in Brazil and China alone.

The experts noted in their findings that the use of expensive and sometimes ineffective technology while low-cost effective interventions are being neglected is a common tragedy found in both wealthy and poor countries.

Vikas Saini, one of the lead authors of the study series and president of the USLown Institute in Boston, said factors driving the global failure to the right level of care include “greed, competing interests and poor information”, which he said combine to create “an ecosystem of poor healthcare delivery.”

Co-lead researcher Shannon Brownlee added: “Patients and citizens need to understand what’s at stake here if their health systems fail to address these twin problems. In the US, we are wasting billions of dollars that should be devoted to improving the nation’s health.”

The study series analyzed the scope, causes and consequences of underuse and overuse of healthcare around the world. It found that both can occur in the same country, the same organization or health facility, and even afflict the same patient.

Underuse leaves patients “vulnerable to avoidable disease and suffering” the researchers said, while overuse causes avoidable harms from tests or treatments at the same time as wasting resources better spent on much-needed services.

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Category: Education, Features

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