Medicine and healthcare are routinely both over- and underused, report experts who carried out a series of studies across the world. This causes avoidable harm and suffering and wasting of precious resources.
Researchers found that upto 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 healthcare.
The study reports soaring rates of Caesarian section deliveries – often in women who do not need them, while the simple use of steroids to prevent premature births has lagged for 40 years.
The World Health Organization estimates that 6.2 million excess C-sections are performed each year – 50 percent of them in Brazil and China alone.
“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,” the experts wrote in a statement about their findings.
“Factors driving the global failure to the right level of care include greed, competing interests and poor information”, said Vikas Saini, one of the lead authors of the study and president of the U.S. Lown Institute in Boston. These combine to create an ecosystem of poor healthcare delivery.
The studies, commissioned by The Lancet journal were conducted by 27 international specialists. It analysed the scope, causes and consequences of underuse and overuse of healthcare around the world. Findings say that both can occur in the same country, the same organization or health facility, and even afflict the same patient.
“Patients and citizens need to understand what’s at stake here if their health systems fail to address these twin problems. In the U.S., we are wasting billions of dollars that should be devoted to improving the nation’s health”, added co-lead researcher Shannon Brownlee.
The researchers also noted that a study in China found 57% of patients received inappropriate antibiotics; 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. They found that rates of inappropriate hysterectomies were 20% in Taiwan and 13% in Switzerland.
While underuse leaves patients vulnerable to avoidable disease and suffering, overuse causes avoidable harms from tests or treatments, also wasting resources better spent on much-needed services.