Measuring low value health care for targeted policy action

In January 2015 The Australian newspaper ran with the headline 'Health eyes $15bn payoff from war on waste', outlining; "Ten per cent of all health expenditure and as much as $15 billion a year could be saved through a concerted effort to reduce wasteful programs, marginal treatments and avoidable errors". However, despite growing awareness of this overuse phenomenon, there is scant hard data on the scale and nature of the problem of marginal treatments in Australia or internationally; a necessary precondition to targeted policy action.

Traditional geographic variation analysis has led the way in flagging the possibility of over- and under-use but it remains an indirect measure of the problem, as it does not necessarily measure appropriateness according to individual clinical indications. This research will be world-leading in directly measuring the prevalence of low-value medical services and prescribed medicines in Australia, coupled with targeted policy initiatives that will assist payers in reducing expenditures on low-value care.

1. This project will measure:

a. the proportion of patients receiving low-value care

b. rates of low-value care

c. the variation in low-value care according to provider (e.g. location) and patient characteristics (e.g. age, gender, location of residence, socioeconomic status)

d. the proportion of government and patient spending devoted to low-value care

2. Estimate the downstream costs of low-value care that arise due to subsequent treatments and management associated with complications and side-effects.

3. Examine whether geographic variation analyses provide a robust measure of low-value care.

4. Work hand-in-hand with policy stakeholders to conduct a dedicated funding policy analysis that would recommend potential payment reform options to reduce low-value practices.

Project team

Professor Sallie Pearson
Medicine & Health

Project collaborators: External

Professor Adam Elshaug
University of Sydney
Professor Ian Scott
University of Queensland

Key contact

Medicine & Health
9385 8895