ArticleBMJ quality & safety2019
Low-value care in Australian public hospitals: prevalence and trends over time.
Article in BMJ quality & safety, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 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
50 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Impact and effect of imaging referral guidelines on patients and radiology services: a systematic review.European radiology · 2025Pooled it
- Determinants of the de-implementation of low-value care: a multi-method study.BMC health services research · 2022Pooled it
- Overuse of diagnostic testing in healthcare: a systematic review.BMJ quality & safety · 2022Pooled it
- Prevalence of Low-Value Care and Its Associations with Patient-Centered Outcomes in Dementia.Journal of Alzheimer's disease : JAD · 2021Trial
- Physician-suggested strategies for deimplementing low-value care in Swedish primary care: a qualitative analysis across system levels.Implementation science communications · 2026Article
- "We might be put into situations we are uncomfortable with, but not exactly told how to deal with them": Health professional students' experiences questioning low-value care practices during work-integrated learning.Anatomical sciences education · 2026Article
- The effect of cultural and linguistic diversity on the timeliness of prostate cancer treatment: a registry-based retrospective cohort study.Cancer causes & control : CCC · 2025Article
- Patterns of diagnostic testing for oesophagogastric cancer-related symptoms in Australian primary care: a retrospective cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Demonstrating the use of population level data to investigate trends in the rate, radiation dose and cost of Computed Tomography across clinical groups: Are there any areas of concern?Journal of medical radiation sciences · 2025Observational
- Value-Based Healthcare-What Does it Look Like for Medical Radiation Sciences in the Australian Context?Journal of medical radiation sciences · 2025Article
- Continuing Professional Development - Medical Imaging.Journal of medical radiation sciences · 2025Article
- Low-Cost, High-Volume Health Services Contribute the Most to Unnecessary Health Spending due to Low-Value Care in Japan.medRxiv : the preprint server for health sciences · 2025Article
- Could Low-Value Diagnostic Tests be Compounding Access Block? A Single-Site, Cross-Sectional Study.Emergency medicine Australasia : EMA · 2025Article
- Primary Care Physician Characteristics and Low-Value Care Provision in Japan.JAMA health forum · 2025Article
- Estimating the societal costs and benefits of de-implementation of low-value care: developing a modelling approach through case assessment.BMC health services research · 2025Article
- Retrospective Cohort Study of Low-Value Hysterectomy Before and After Publication of the National Heavy Bleeding Clinical Care Standard in Regional Victoria.The Australian journal of rural health · 2025Article
- Associations of Chinese diagnosis-related group system with low-value coronary revascularisation: an interrupted time series analysis.BMJ open · 2025Observational
- Is low-value care for persistent musculoskeletal pain more common in rural than urban areas? A scoping review.BMC health services research · 2025Article
- Selecting indicators for the measurement of low-value care using German claims data: A three-round modified Delphi panel.PloS one · 2025Article
- Faecal immunochemical test to triage patients with possible colorectal cancer symptoms: insights from the New Zealand FIT for symptomatic pilot.Frontiers in gastroenterology (Lausanne, Switzerland) · 2025Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine 27 low-value procedures, as defined by international recommendations, in New South Wales public hospitals.
designAnalysis of admitted patient data for financial years 2010-2011 to 2016-2017.
main outcome measuresNumber and proportion of episodes identified as low value by two definitions (narrower and broader), associated costs and bed-days, and variation between hospitals in financial year 2016-2017; trends in numbers of low-value episodes from 2010-2011 to 2016-2017.
resultsFor 27 procedures in 2016-2017, we identified 5079 (narrower definition) to 8855 (broader definition) episodes involving low-value care (11.00%-19.18% of all 46 169 episodes involving these services). These episodes were associated with total inpatient costs of $A49.9 million (narrower) to $A99.3 million (broader), which was 7.4% (narrower) to 14.7% (broader) of the total $A674.6 million costs for all episodes involving these procedures in 2016-2017, and involved 14 348 (narrower) to 29 705 (broader) bed-days. Half the procedures accounted for less than 2% of all low-value episodes identified; three of these had no low-value episodes in 2016-2017. The proportion of low-value care varied widely between hospitals. Of the 14 procedures accounting for most low-value care, seven showed decreasing trends from 2010-2011 to 2016-2017, while three (colonoscopy for constipation, endoscopy for dyspepsia, sentinel lymph node biopsy for melanoma in situ) showed increasing trends.
conclusionsLow-value care in this Australian public hospital setting is not common for most of the measured procedures, but colonoscopy for constipation, endoscopy for dyspepsia and sentinel lymph node biopys for melanoma in situ require further investigation and action to reverse increasing trends. The variation between procedures and hospitals may imply different drivers and potential remedies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.