Think before you go under the knife. Study finds overuse of health care worldwide

Experts carried out a series of studies across the world and found that medicine and health care are routinely over- and underused, causing avoidable harm and wasting medical resources

Up to 70% of hysterectomies in the United States, a quarter of knee replacements in Spain and more than half the antibiotics prescribed in China are inappropriate, overused health care, researchers said on Monday.

Experts who carried out a series of studies across the world found that medicine and health care are routinely both over- and underused, causing avoidable harm and suffering and wasting precious resources.

The studies, commissioned by The Lancet journal and conducted by 27 international specialists, also found rates of Caesarian section deliveries are soaring – often in women who do not need them – while the simple use of steroids to prevent premature births has lagged for 40 years.

“A common tragedy in both wealthy and poor countries is the use of expensive and sometimes ineffective technology while low-cost effective interventions are neglected,” a statement issued by the specialists read.

The World Health Organization estimates that 6.2 million excess C-sections are performed each year: 50% of them in Brazil and China alone.

The researchers noted that a study in China found 57% of patients received inappropriate antibiotics.

Co-lead researcher Shannon Brownlee added: “Patients and citizens need to understand what’s at stake here if their health systems fail to address these twin problems. In the US, we are wasting billions of dollars that should be devoted to improving the nation’s health.”

The study series analysed the scope, causes and consequences of underuse and overuse of health care around the world. It found that both can occur in the same country, the same organization or health facility, and even afflict the same patient.

The researchers noted that a study in China found 57% of patients received inappropriate antibiotics; that inappropriate hysterectomies in the United States range from 16 to 70%; and inappropriate total-knee replacement rates were 26% in Spain and 34% in the United States.

Rates of inappropriate hysterectomies were 20% in Taiwan and 13% in Switzerland.

Underuse leaves patients “vulnerable to avoidable disease and suffering” the researchers said, while overuse causes avoidable harms from tests or treatments at the same time as wasting resources better spent on much-needed services.

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