Researchers at Johns Hopkins University Develop Methods of Measurement for Health Care Overuse
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By: Emily Carpintero Nov. 10, 2017
Healthcare utilization has been highlighted as a key measure to the quality of care provided on a national, regional and site specific level. Empirical data is often misconstrued because of the amount of claims and the various conditions being reviewed at once. Over the past few years, medical professionals from Johns Hopkins University in Maryland conducted multiple studies of data to determine patterns that could potentially be interfered with to lower hospitalization usage and costs.
Study 1: In 2013, a critical review was published by researchers at John Hopkins University showing their interest and professional review of current methods being developed to address issues of health care overuse. Overused procedures have been deemed costly and often systematic and unbeneficial to the patients, but in order to address the issue, validated measures need to be developed or improved. In their vast review of published studies, the researchers found that many existing measurements have been highly focused on certain areas including diagnostic, therapeutic and imaging services. These are some of the most commonly overused services, but the researchers felt that rather than focusing on specific areas, patterns should be identified through observational studies to determine patients who do not benefit from overused procedures.
Study 2: A retrospective data analysis was conducted to develop algorithms that could measure occurrences of overused procedures. The data collected was first analyzed by the researchers to determine whether the procedures were ultimately unbeneficial to the clinical outcome. The data came from an environmental scan conducted at a national level to identify if any variations existed across different hospital referral regions (HRRs). The study highlighted over 600 overused procedures. Overused procedures and the frequencies of each varied amongst different regions. There were 20 overused procedures, with the majority categorized under diagnostic testing, that had a higher than average frequency of occurrence. The study demonstrated that the most overused procedures came from routine-based patient care upon index admissions.
Study 3: Using results from their previous study, the Johns Hopkins University researchers furthered their study to create a more comprehensive measurement with a validated compared association to total costs, 30-day postdischarge mortality rates, and overall mortality rates across all HRRs. They were able to confirm a positive correlation between the Overuse Index and total costs and 30-day postdischarge mortality rates. There was no positive nor negative correlation between the Overuse Index and overall mortality rates across all HRRs. The researchers plan to further their research to develop a validated predictive tool to lower health care overuse.
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