ArticleHealth services research2018
Low-Value Service Use in Provider Organizations.
Article in Health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Patient, provider, and system-level factors associated with preoperative cardiac testing: A systematic review.Journal of hospital medicine · 2023Pooled it
- The Impact of Choosing Wisely Interventions on Low-Value Medical Services: A Systematic Review.The Milbank quarterly · 2021Pooled it
- Hospital-physician integration and Medicare spending: Evidence from stable angina.Health services research · 2025Article
- Primary Care Practice Telehealth Use and Low-Value Care Services.JAMA network open · 2024Article
- Analyzing health outcomes measured as bounded counts.Journal of health economics · 2024Article
- Impact of a quality programme on overindication of surgeries for endometriosis and cholecystectomies.BMJ open quality · 2023Article
- Racial differences in low value care among older adult Medicare patients in US health systems: retrospective cohort study.BMJ (Clinical research ed.) · 2023Article
- Measuring low-value care in hospital discharge records: evidence from China.The Lancet regional health. Western Pacific · 2023Article
- Longitudinal Patterns in Testosterone Prescribing After US FDA Safety Communication in 2014.Joint Commission journal on quality and patient safety · 2023Article
- Who's Accountable? Low-Value Care Received By Medicare Beneficiaries Outside Of Their Attributed Health Systems.Health affairs (Project Hope) · 2023Article
- Variation in Low-Value Service Use Across Veterans Affairs Facilities.Journal of general internal medicine · 2023Article
- Development and validation of a new ICD-10-based screening colonoscopy overuse measure in a large integrated healthcare system: a retrospective observational study.BMJ quality & safety · 2023Observational
- Stratification of spine patients based on self-reported clinical symptom classes: Evaluation of long-term outcomes and subsequent interventions.North American Spine Society journal · 2023Article
- Performance on Patient Experience Measures of Former Chief Medical Residents as Physician Exemplars Chosen by the Profession.JAMA internal medicine · 2023Article
- Organizational influences on the use of low-value care in primary health care - a qualitative interview study with physicians in Sweden.Scandinavian journal of primary health care · 2022Article
- Assessing patient, physician, and practice characteristics predicting the use of low-value services.Health services research · 2022Article
- Practice Billing for Medicare Advance Care Planning Across the USA.Journal of general internal medicine · 2022Article
- Low-Value Prostate-Specific Antigen Test for Prostate Cancer Screening and Subsequent Health Care Utilization and Spending.JAMA network open · 2022Article
- Updating a Claims-Based Measure of Low-Value Services Applicable to Medicare Fee-for-Service Beneficiaries.Journal of general internal medicine · 2022Article
- Identifying drivers of health care value: a scoping review of the literature.BMC health services research · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectiveTo assess whether provider organizations exhibit distinct profiles of low-value service provision. DATA SOURCES: 2007-2011 Medicare fee-for-service claims and enrollment data. STUDY
designUse of 31 services that provide minimal clinical benefit was measured for 4,039,733 beneficiaries served by 3,137 provider organizations. Variation across organizations, persistence within organizations over time, and correlations in use of different types of low-value services within organizations were estimated via multilevel modeling, with adjustment for beneficiary sociodemographic and clinical characteristics. PRINCIPAL
findingsOrganizations provided 45.6 low-value services per 100 beneficiaries on average, with considerable variation across organizations (90th/10th percentile ratio, 1.78; 95 percent CI, 1.72-1.84), including substantial between-organization variation within hospital referral regions (90th/10th percentile ratio, 1.66; 95 percent CI, 1.60-1.71). Low-value service use within organizations was highly correlated over time (r, 0.98; 95 percent CI, 0.97-0.99) and positively correlated between 13 of 15 pairs of service categories (average r, 0.26; 95 percent CI, 0.24-0.28), with the greatest correlation between low-value imaging and low-value cardiovascular testing and procedures (r, 0.54).
conclusionsUse of low-value services in provider organizations exhibited substantial variation, high persistence, and modest consistency across service types. These findings are consistent with organizations shaping the practice patterns of affiliated physicians.
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Registered trials
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