The most likely explanation for continued overuse of non-beneficial, potentially harmful care is that reducing inappropriate care "has not been a real focus of the quality of care movement," despite efforts to reduce the estimated $280 billion that is spent each year on delivery of services "for which the risks exceed the benefits," they said.
The analysis looked at nine types of care classified as underused, 11 types of care classified as overused, and two types of care classified as misused between 1999 and 2009; 79,083 patient visits during the earlier period and 102,980 during the latter period.
Data was drawn from the National Ambulatory Medical Care Survey and outpatient statistics of the National Hospital Ambulatory Medical Care Survey.
For specific "overuse measures," the researchers found that in addition to prostate cancer screening in men greater than age 74, which went from 3.5% in 1999 to 5.7% in 2009, six other types of "overuse" care increased.
For example, screening EKG in adults during a general medical exam went from 6.1% in 1999 to 11.3% in 2009; screening x-ray in adults with a general medical exam went from 4.7% to 7%; screening with complete blood counts for adults during a general medical exam went from 22.3% to 37.9%; mammography for women over age 74 went from 2.1% to 2.6%; imaging for back pain in adults older than age 18 went from 19.1% to 22.8%; and antibiotics for an upper respiratory tract infection went from 37.8% to 40.2%.