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Title of Journal: J GEN INTERN MED

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Abbravation: Journal of General Internal Medicine

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Springer US

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DOI

10.1007/s10592-012-0325-2

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ISSN

1525-1497

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Choosing Wisely Prevalence and Correlates of Low

Authors: Carrie H Colla Nancy E Morden Thomas D Sequist William L Schpero Meredith B Rosenthal
Publish Date: 2014/11/06
Volume: 30, Issue: 2, Pages: 221-228
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Abstract

Using Medicare data from 2006 to 2011 we created claimsbased algorithms to measure the prevalence of 11 Choosing Wiselyidentified lowvalue services and examined geographic variation across hospital referral regions HRRs We created a composite lowvalue care score for each HRR and used linear regression to identify regional characteristics associated with more intense use of lowvalue servicesThe national average annual prevalence of the selected Choosing Wisely lowvalue services ranged from 12 upper urinary tract imaging in men with benign prostatic hyperplasia to 465 preoperative cardiac testing for lowrisk noncardiac procedures Prevalence across HRRs varied significantly Regional characteristics associated with higher use of lowvalue services included greater overall per capita spending a higher specialist to primary care ratio and higher proportion of minority beneficiariesIdentifying and measuring lowvalue health services is a prerequisite for improving quality and eliminating waste Our findings suggest that the delivery of wasteful and potentially harmful services may be a fruitful area for further research and policy intervention for HRRs with higher percapita spending These findings should inform action by physicians health systems policymakers payers and consumer educators to improve the value of health care by targeting services and areas with greater use of potentially inappropriate care

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