Monitoring and addressing overdiagnosis and overtreatment to reduce low-value care across all healthcare settings

Robin M. Turner, Magnolia Cardona

Research output: Contribution to conferencePresentationEducation

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Abstract

The concepts of overdiagnosis and overtreatment are now emerging more often in the medical literature as awareness of their implications for psychosocial burden and unsustainable cost become clearer. Researchers now have more tools to investigate these widespread low-value care practices in hospitals, primary care and residential aged care.

There are an increasing number of treatment options available to people with little evidence on whether choice of treatment helps. Recent advances in randomised control trial design now incorporate patient preferences for treatment allowing policy makers to better understand whether choice is beneficial or harmful. Ideally this will lead to informed decision making for treatments, including introducing conversations around whether treatment is beneficial at all.
One example where preference is important and where over treatment can occur is with people near the end of life. Older people with progressive, irreversible illness use acute hospitals services, tests, and multiple medications in the last year of life at rates that are questionable given the expected low benefit. This overuse of treatments inflicts unnecessary patient suffering, creates false hope of patient survival and frustration among clinical staff, and generates unsustainable costs. Tools for predicting people at risk of death within the year are available for free but underused. Timely honest conversations on non- aggressive options including supportive care are not occurring. We argue that
public awareness and professional training can reduce this resource waste while improving quality end-of-life.
Original languageEnglish
Publication statusUnpublished - 2019
Event11th Health Services and Policy Research Conference - Auckland, New Zealand
Duration: 4 Dec 20196 Dec 2019
Conference number: 11th
http://www.healthservicesconference.com.au/hsraanz2019/

Conference

Conference11th Health Services and Policy Research Conference
Abbreviated titleHSRAANZ
CountryNew Zealand
CityAuckland
Period4/12/196/12/19
Internet address

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Delivery of Health Care
Therapeutics
Hope
Costs and Cost Analysis
Frustration
Patient Preference
Medical Overuse
Healthcare
Monitoring
Administrative Personnel
Psychological Stress
Primary Health Care
Decision Making
Quality of Life
Research Personnel
Survival
Costs
End of life

Cite this

Turner, R. M., & Cardona, M. (2019). Monitoring and addressing overdiagnosis and overtreatment to reduce low-value care across all healthcare settings. 11th Health Services and Policy Research Conference, Auckland, New Zealand.
Turner, Robin M. ; Cardona, Magnolia. / Monitoring and addressing overdiagnosis and overtreatment to reduce low-value care across all healthcare settings. 11th Health Services and Policy Research Conference, Auckland, New Zealand.
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Turner, RM & Cardona, M 2019, 'Monitoring and addressing overdiagnosis and overtreatment to reduce low-value care across all healthcare settings' 11th Health Services and Policy Research Conference, Auckland, New Zealand, 4/12/19 - 6/12/19, .

Monitoring and addressing overdiagnosis and overtreatment to reduce low-value care across all healthcare settings. / Turner, Robin M.; Cardona, Magnolia.

2019. 11th Health Services and Policy Research Conference, Auckland, New Zealand.

Research output: Contribution to conferencePresentationEducation

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AB - The concepts of overdiagnosis and overtreatment are now emerging more often in the medical literature as awareness of their implications for psychosocial burden and unsustainable cost become clearer. Researchers now have more tools to investigate these widespread low-value care practices in hospitals, primary care and residential aged care. There are an increasing number of treatment options available to people with little evidence on whether choice of treatment helps. Recent advances in randomised control trial design now incorporate patient preferences for treatment allowing policy makers to better understand whether choice is beneficial or harmful. Ideally this will lead to informed decision making for treatments, including introducing conversations around whether treatment is beneficial at all.One example where preference is important and where over treatment can occur is with people near the end of life. Older people with progressive, irreversible illness use acute hospitals services, tests, and multiple medications in the last year of life at rates that are questionable given the expected low benefit. This overuse of treatments inflicts unnecessary patient suffering, creates false hope of patient survival and frustration among clinical staff, and generates unsustainable costs. Tools for predicting people at risk of death within the year are available for free but underused. Timely honest conversations on non- aggressive options including supportive care are not occurring. We argue thatpublic awareness and professional training can reduce this resource waste while improving quality end-of-life.

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Turner RM, Cardona M. Monitoring and addressing overdiagnosis and overtreatment to reduce low-value care across all healthcare settings. 2019. 11th Health Services and Policy Research Conference, Auckland, New Zealand.