The problem of overuse.
نویسنده
چکیده
Many Veterans Affairs physicians are familiar with the steady stream of reminders generated by our electronic medical record system to order laboratory and screening tests. These reminders help clinicians meet guidelines and performance targets for screening and prevention. However, the article by Virani and colleagues demonstrating substantial overuse of repeated lipid testing in a Veterans Affairs network once again shows us how performance measurement may lead to overuse. As noted by Drozda in his commentary, although the cost of an individual lipid test is modest, the effect of high-volume, modest-cost tests on the health system is large. Furthermore, the price to a patient asked to take an additional hour or two off from work to sit in the laboratory waiting room may not be modest at all, especially if he or she needs to return for a fasting lipid panel. Manyveteranshavegreatlybenefited fromthe focusof the Department of Veterans Affairs on quality and performance measurement.However, the evidence that performancemeasurement sometimes leads tooveruseandovertreatment is accumulating. The Department of Veterans Affairs is a leader in quality of care andperformancemeasurement. It should now lead a culture change to discourage overuse, per the suggestions by Virani and colleagues and by Drozda. Higher frequency does not always mean better care.
منابع مشابه
Relationship between the provision of injection services in ambulatory physician offices and prescribing injectable medicines
Background: Overuse of injections is a common problem in many low-income and middle income countries. Whil
متن کاملRelationship between the provision of injection services in ambulatory physician offices and prescribing injectable medicines
Background: Overuse of injections is a common problem in many low-income and middle income countries. Whil
متن کاملOveruse and underuse of pulmonary CT angiography in patients with suspected pulmonary embolism
Background: The aim of the present study was to evaluate the utilization and diagnostic yields of CT pulmonary angiography (CTPA) using the Revised Geneva score and Wells’ criteria, in patients with suspected pulmonary embolism (PE). Methods: One hundred and twelve adult patients underwent CTPA for suspected PE were participated in this study. The outcome was positive or neg...
متن کاملOveruse injuries in youth basketball and floorball
BACKGROUND The popularity of team sports is growing among young people. High training volume and intensity may predispose young athletes to overuse injuries. Research to date has tended to focus on acute injuries rather than overuse injuries. The purpose of this study was to examine the occurrence, nature, and severity of overuse injuries in youth basketball and floorball, with the hypothesis t...
متن کاملCelecoxib or Prednisolone for Treatment of Medication Overuse Headache: A Randomized, Double-Blind Clinical Trial in Migrainous Patients
Background:Treatment of Medication Overuse Headache (MOH) is yet under debate and Celecoxib as a Cyclooxygenase 2 (COX2) -inhibitor has not been tried widely as a pain relief drug for this type of headaches in migrainous patients. Objectives: comparing the efficacy of celecoxib versus prednisolone for withdrawal period of MOH. Materials & Methods: A double-blind, randomized clinical tri...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- JAMA internal medicine
دوره 173 15 شماره
صفحات -
تاریخ انتشار 2013