Observational studyBMJ open2022
Prevalence and changes of low-value care at acute care hospitals: a multicentre observational study in Japan.
Observational study in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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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.
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.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact and effect of imaging referral guidelines on patients and radiology services: a systematic review.European radiology · 2025Pooled it
- Addressing low-value care (LVC) in Asia: a narrative review of Choosing Wisely and other initiatives across Asia.BMJ open quality · 2026Review
- Comparison of in-hospital outcomes and processes of care by patient and physician sex: a single-centre retrospective cohort study.BMJ open · 2026Article
- Trends in Nonsurgical Interventions and Analgesic Medications for Low Back Pain: A Large Claims Database Study in Japan.Pain practice : the official journal of World Institute of Pain · 2025Article
- Analysis of the Incidence and Severity of Cellulitis During the COVID-19 Pandemic in Japan.The Journal of dermatology · 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
- Primary Care Physician Characteristics and Low-Value Care Provision in Japan.JAMA health forum · 2025Article
- Changes in inpatient and outpatient stroke admissions during COVID-19: a difference-in-differences analysis based on claims data from 242 acute care hospitals in Japan.BMJ public health · 2025Article
- In-Hospital Deaths From Ambulatory Care-Sensitive Conditions Before and During the COVID-19 Pandemic in Japan.JAMA network open · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe aimed to examine the use and factors associated with the provision of low-value care in Japan.
designA multicentre observational study.
settingRoutinely collected claims data that include all inpatient and outpatient visits in 242 large acute care hospitals (accounting for approximately 11% of all acute hospitalisations in Japan).
participants345 564 patients (median age (IQR): 62 (40-75) years; 182 938 (52.9%) women) seeking care at least once in the hospitals in the fiscal year 2019. PRIMARY AND SECONDARY OUTCOME MEASURES: We identified 33 low-value services, as defined by clinical evidence, and developed two versions of claims-based measures of low-value services with different sensitivity and specificity (broader and narrower definitions). We examined the number of low-value services, the proportion of patients receiving these services and the proportion of total healthcare spending incurred by these services in 2019. We also evaluated the 2015-2019 trends in the number of low-value services.
resultsServices identified by broader low-value care definition occurred in 7.5% of patients and accounted for 0.5% of overall annual healthcare spending. Services identified by narrower low-value care definition occurred in 4.9% of patients and constituted 0.2% of overall annual healthcare spending. Overall, there was no clear trend in the prevalence of low-value services between 2015 and 2019. When focusing on each of the 17 services accounting for more than 99% of all low-value services identified (narrower definition), 6 showed decreasing trends from 2015 to 2019, while 4 showed increasing trends. Hospital size and patients' age, sex and comorbidities were associated with the probability of receiving low-value service.
conclusionsA substantial number of patients received low-value care in Japan. Several low-value services with high frequency, especially with increasing trends, require further investigation and policy interventions for better resource allocation.
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