Overutilization
Unnecessary health care (overutilization, overuse, or overtreatment) is health care provided with a higher volume or cost than is appropriate. In the United States, where health care costs are the highest as a percentage of GDP, overuse was the predominant factor in its expense, accounting for about a third of its health care spending ($750 billion out of $2.6 trillion) in 2012. Factors that drive overuse include paying health professionals more to do more (fee-for-service), defensive medicine to protect against litigiousness, and insulation from price sensitivity in instances where the consumer is not the payer—the patient receives goods and services but insurance pays for them (whether public insurance, private, or both). Such factors leave many actors in the system (doctors, patients, pharmaceutical companies, device manufacturers) with inadequate incentive to restrain health care prices or overuse. This drives payers, such as national health insurance systems or the U.S. ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Fee-for-service
Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately. In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care. However evidence of the effectiveness of FFS in improving health care quality is mixed, without conclusive proof that these programs either succeed or fail. Similarly, when patients are shielded from paying (cost-sharing) by health insurance coverage, they are incentivized to welcome any medical service that might do some good. Fee-for-services raises costs, and discourages the efficiencies of integrated care. A variety of reform efforts have been attempted, recommended, or initiated to reduce its influence (such as moving towards bundled payments and capitation). In capitation, physicians are not incentivized to perform procedures, including necessary ones, because they are not paid anything extra for performing them. FFS is t ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Health Care
Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health professionals and allied health fields. Medicine, dentistry, pharmacy, midwifery, nursing, optometry, audiology, psychology, occupational therapy, physical therapy, athletic training, and other health professions all constitute health care. It includes work done in providing primary care, secondary care, and tertiary care, as well as in public health. Access to health care may vary across countries, communities, and individuals, influenced by social and economic conditions as well as health policies. Providing health care services means "the timely use of personal health services to achieve the best possible health outcomes". Factors to consider in terms of health care access include financial limitations (such as insurance coverage), geo ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Medical Necessity
Medical necessity is a legal doctrine in the United States related to activities that may be justified as reasonable, necessary, and/or appropriate based on evidence-based clinical standards of care. In contrast, unnecessary health care lacks such justification. Other countries may have medical doctrines or legal rules covering broadly similar grounds. The term clinical medical necessity is also used. Implementations of doctrine Medicare Medicare pays for medical items and services that are "reasonable and necessary" or "appropriate" for a variety of purposes. By statute, Medicare may pay only for items and services that are "reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member" unless there is another statutory authorization for payment. Medicare has a number of policies that describe coverage criteria, including National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs), ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Institute Of Medicine
The National Academy of Medicine (NAM), formerly called the Institute of Medicine (IoM) until 2015, is an American nonprofit, non-governmental organization. The National Academy of Medicine is a part of the National Academies of Sciences, Engineering, and Medicine, along with the National Academy of Sciences (NAS), National Academy of Engineering (NAE), and the National Research Council (NRC). The National Academy of Medicine provides national and international advice on issues relating to health, medicine, health policy, and biomedical science. It aims to provide unbiased, evidence-based, and authoritative information and advice concerning health and science policy to policy-makers, professionals, leaders in every sector of society, and the public at large. Operating outside the framework of the U.S. federal government, it relies on a volunteer workforce of scientists and other experts, operating under a formal peer-review system. As a national academy, the organization a ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Choosing Wisely
Choosing Wisely is a United States-based health educational campaign, led by the ABIM Foundation (American Board of Internal Medicine), about unnecessary health care. The campaign identifies over 500 tests and procedures and encourages doctors and patients to discuss, research, and possibly get second opinions, before proceeding with them. To conduct the campaign, the ABIM Foundation asks medical specialty societies to make five to ten recommendations for preventing overuse of a treatment in their field. The foundation then publicizes this information, and the medical specialty societies disseminate it to their members. The campaign has garnered both praise and criticism, and some of its ideas have spread to other countries. It does not include evaluation of its effects on costs, on discussions or on medical outcomes. Some doctors have said they lack time for the recommended discussions. History In 2002 the ABIM Foundation published ''Medical professionalism in the new millenni ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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The New York Times
''The New York Times'' (''the Times'', ''NYT'', or the Gray Lady) is a daily newspaper based in New York City with a worldwide readership reported in 2020 to comprise a declining 840,000 paid print subscribers, and a growing 6 million paid digital subscribers. It also is a producer of popular podcasts such as '' The Daily''. Founded in 1851 by Henry Jarvis Raymond and George Jones, it was initially published by Raymond, Jones & Company. The ''Times'' has won 132 Pulitzer Prizes, the most of any newspaper, and has long been regarded as a national " newspaper of record". For print it is ranked 18th in the world by circulation and 3rd in the U.S. The paper is owned by the New York Times Company, which is publicly traded. It has been governed by the Sulzberger family since 1896, through a dual-class share structure after its shares became publicly traded. A. G. Sulzberger, the paper's publisher and the company's chairman, is the fifth generation of the family to head the pa ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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RAND Corporation
The RAND Corporation (from the phrase "research and development") is an American nonprofit global policy think tank created in 1948 by Douglas Aircraft Company to offer research and analysis to the United States Armed Forces. It is financed by the Federal government of the United States, U.S. government and private Financial endowment, endowment, corporations, university, universities and private individuals. The company assists other governments, international organizations, private companies and foundations with a host of defense and non-defense issues, including healthcare. RAND aims for interdisciplinary and quantitative problem solving by translating theory, theoretical concepts from formal economics and the Outline of physical science, physical sciences into novel applications in other areas, using applied science and operations research. Overview RAND has approximately 1,850 employees. Its American locations include: Santa Monica, California (headquarters); Arlington ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Thérèse Stukel
Thérèse A. Stukel is a Canadian statistician who works as a senior core scientist at the Institute for Clinical Evaluative Sciences, as a professor in the Institute of Health Policy, Management and Evaluation of the University of Toronto, and as an adjunct professor of epidemiology and of The Dartmouth Institute for Health Policy and Clinical Practice at Dartmouth College. Topics in her research include surgical mortality, the effects of regional variations in healthcare spending, and heart-related health care. Stukel studied mathematics at the University of Ottawa, graduating in 1973. and earned a maîtrise (one-year master's degree) in applied mathematics from the University of Grenoble in 1974. After completing a diploma in advanced studies in statistics jointly from Pierre and Marie Curie University and Paris Dauphine University in 1975, she returned to Canada for a Ph.D. in statistics at the University of Toronto in 1983. Her dissertation, supervised by David F. Andrews, ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Ann Intern Med
''Annals of Internal Medicine'' is an academic medical journal published by the American College of Physicians (ACP). It is one of the most widely cited and influential specialty medical journals in the world. ''Annals'' publishes content relevant to the field of internal medicine and related sub-specialties. ''Annals'' publishes a wide variety of original research, review articles, practice guidelines, and commentary relevant to clinical practice, health care delivery, public health, health care policy, medical education, ethics, and research methodology. In addition, the journal publishes personal narratives that convey the feeling and the art of medicine. Selected articles in the journal are open access; these include patient oriented content and Clinical Guidelines (and related reviews). Impact factor The most recent (2021) Impact Factor for ''Annals of Internal Medicine'' is 51.598 (Clarivate Analytics). According to the new 2021 Journal Citations Reports from Clarivate ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Overconsumption
Overconsumption describes a situation where a consumer overuses their available goods and services to where they can't, or don't want to, replenish or reuse them. In microeconomics, this may be described as the point where the marginal cost of a consumer is greater than their marginal utility. The term overconsumption is quite controversial in use and does not necessarily have a single unifying definition. When used to refer to natural resources to the point where the environment is negatively affected, is it synonymous with the term overexploitation. However, when used in the broader economic sense, overconsumption can refer to all types of goods and services, including manmade ones, e.g. "the overconsumption of alcohol can lead to alcohol poisoning". Overconsumption is driven by several factors of the current global economy, including forces like consumerism, planned obsolescence, economic materialism, and other unsustainable business models and can be contrasted with sustaina ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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This American Life
''This American Life'' (''TAL'') is an American monthly hour-long radio program produced in collaboration with Chicago Public Media and hosted by Ira Glass. It is broadcast on numerous public radio stations in the United States and internationally, and is also available as a free weekly podcast. Primarily a journalistic non-fiction program, it has also featured essays, memoirs, field recordings, short fiction, and found footage. The first episode aired on November 17, 1995, under the show's original title, ''Your Radio Playhouse''. The series was distributed by Public Radio International until June 2014, when the program became self-distributed with Public Radio Exchange delivering new episodes to public radio stations. A This American Life (TV series), television adaptation of the show ran for two seasons on the Showtime (TV network), Showtime cable network between June 2007 and May 2008. Format Each week's show has a theme, explored in several "acts". On occasion, an entir ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Unwarranted Variation
Unwarranted variation (or geographic variation) in health care service delivery refers to medical practice pattern variation that cannot be explained by illness, medical need, or the dictates of evidence-based medicine. It is one of the causes of low value care often ignored by health systems. Definition Unwarranted variation (or geographic variation) in health care service delivery refers to differences that cannot be explained by personal preference, illness, medical need, or the dictates of evidence-based medicine. The term was coined by Dr. John Wennberg. Unwarranted variation reveals three areas: * Overuse of treatments (or overutilisation) such that more harm than good is being done *Underuse of treatments such that cost-effective interventions are not being provided *Inequity of care (a subset of underuse) such that parts of the population are not accessing treatment, possibly because of their social background. Supply-sensitive care, which is strongly correlated with heal ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |