ArticleBMC health services research2019
Systemic overuse of health care in a commercially insured US population, 2010-2015.
Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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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.
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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.
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Who cites it
18 citing papers in PubMed.
- Addressing the overuse-underuse paradox in healthcare.Medicine, health care, and philosophy · 2025Article
- The effect of overuse by primary healthcare institutions on medical expenses: an empirical study from the western regions of China.Frontiers in public health · 2025Article
- Shifts in total medical expenses by health coverage changes among the low-income, medically vulnerable population in South Korea.Environmental health and preventive medicine · 2025Article
- Associations of care continuity and care coordination with the overuse of healthcare services: a nationwide population-based study.BMC health services research · 2024Article
- Private practice dentists' conceptions of overtreatment: A qualitative study from Norway.Acta odontologica Scandinavica · 2024Article
- Medicaid Insurance is Associated With Decreased MRI Use for Ankle Sprains Compared With Private Insurance: A Retrospective Large-database Analysis.Clinical orthopaedics and related research · 2024Article
- Reducing Overuse by Healthcare Systems: A Positive Deviance Analysis.Journal of general internal medicine · 2023Article
- Clinical chemistry laboratory test overuse in a cardiology clinic: a single-center study.Journal of medicine and life · 2023Article
- Mental health outcomes in parents of children with a cancer diagnosis in Sweden: A nationwide cohort study.EClinicalMedicine · 2023Article
- Article
- Ethical issues with geographical variations in the provision of health care services.BMC medical ethics · 2022Article
- Factors Associated With Overuse of Health Care Within US Health Systems: A Cross-sectional Analysis of Medicare Beneficiaries From 2016 to 2018.JAMA health forum · 2022Article
- Low-value care and excess out-of-pocket expenditure among older adults with incident cancer - A machine learning approach.Journal of cancer policy · 2021Article
- Trends in Low-Value Health Service Use and Spending in the US Medicare Fee-for-Service Program, 2014-2018.JAMA network open · 2021Article
- Development of a Simple Index to Measure Overuse of Diagnostic Testing at the Hospital Level Using Administrative Data.Journal of hospital medicine · 2021Article
- External Validation of and Factors Associated with the Overuse Index: a Nationwide Population-Based Study from Taiwan.Journal of general internal medicine · 2021Article
- The impact of global budget payment reform on systemic overuse in Maryland.Healthcare (Amsterdam, Netherlands) · 2020Article
- Understanding Geographic Variation in Systemic Overuse Among the Privately Insured.Medical care · 2020Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundOveruse is a leading contributor to the high cost of health care in the United States. Overuse harms patients and is a definitive waste of resources. The Johns Hopkins Overuse Index (JHOI) is a normalized measure of systemic health care services overuse, generated from claims data, that has been used to describe overuse in Medicare beneficiaries and to understand drivers of overuse. We aimed to adapt the JHOI for application to a commercially insured US population, to examine geographic variation in systemic overuse in this population, and to analyze trends over time to inform whether systemic overuse is an enduring problem.
methodsWe analyzed commercial insurance claims from 18 to 64 year old beneficiaries. We calculated a semiannual JHOI for each of the 375 Metropolitan Statistical Areas and 47 rural regions of the US. We generated maps to examine geographic variation and then analyzed each region's change in their JHOI quintile from January 2011 to June 2015.
resultsThe JHOI varied markedly across the US. Across the country, rural regions tended to have less systemic overuse than their MSA counterparts (p < 0.01). Regional systemic overuse is positively correlated from one time period to the next (p < 0.001). Between 2011 and 2015, 53.7% (N = 226) of regions remained in the same quintile of the JHOI. Eighty of these regions had a persistently high or persistently low JHOI throughout study duration.
conclusionsThe systemic overuse of health care resources is an enduring, regional problem. Areas identified as having a persistently high rate of systemic overuse merit further investigation to understand drivers and potential points of intervention.
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