Overuse and Vulnerable Patients
Overuse, or care that has a greater potential for harm than benefit, is widespread in American medicine, with severe effects on both quality of care and health care costs. But for people living in poverty, limited access to care has led to higher levels of morbidity and mortality.
While some attribute poor outcomes directly to access issues, a growing body of research shows that overuse is prevalent in Medicaid and uninsured patients and in minority patients of all income levels. Several studies have supported that low-value care is common among patients without insurance or with Medicaid, and that physicians practice similar rates of low-value and high-value care regardless of their patients’ insurance status.
A recent study of Medicare beneficiaries by William Schpero et al suggests there is “a possible double jeopardy for minority patients: long understood to be at risk of receiving less effective care, they appear often to be at risk of receiving more ineffective care.” Additionally, because the high cost of care is one of the greatest barriers to access, low-income health care consumers are at increased risk of financial harm from tests and treatments that have little to no benefit.
In a new white paper, the ABIM Foundation, with support from the Robert Wood Johnson Foundation, explores the perceptions and beliefs about overuse among historically marginalized patients based on a series of four focus groups conducted in Philadelphia and Hartford, CT.
Download the white paper, Communicating About Overuse with Vulnerable Populations.
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