New U-M poll looks at overuse of health care

March 1, 2018  //  FOUND IN: Michigan Medicine News


Health care providers and older patients may disagree more often than either of them suspects about whether a particular medical test or medicine is truly necessary, according to findings from a new poll of Americans over age 50. Improving communication about that mismatch of opinions, the poll suggests, might reduce the use of unneeded scans, screenings, medications and procedures — and health care costs, as well.

Only 14 percent of people over age 50 believe that more is usually better when it comes to health care, according to the new findings from the National Poll on Healthy Aging.

But one in four say their health providers often order tests or prescribe drugs that they don’t think they really need. One in six said it had happened in the last year — but about half of them followed through with the test or filled the prescription anyway.

On the flip side, about 1 in 10 of those polled said their doctor or other health provider had told them that a test or medication they’d asked for wasn’t needed. Most of them said the provider explained why, but 40 percent didn’t completely understand the explanation.

The poll was conducted in a nationally representative sample of 2,007 Americans between the ages of 50 and 80 by the U-M Institute for Healthcare Policy and Innovation. It was sponsored by AARP and Michigan Medicine.

“The new findings suggest patients and providers need to work together more to prevent overuse of health care services that provide the least value to patients,” said U-M’s Jeffrey Kullgren, M.D., M.S., M.P.H., the assistant professor of internal medicine who designed the poll and analyzed its results.

“Patients should speak up when they aren’t sure if a test or medication recommended to them is needed,” he said. “And providers need to communicate about how a particular service will — or will not — affect the patient’s health, both when they’re recommending it and when a patient has requested it.”

Kullgren points to the “Choosing Wisely” website created by medical professional groups as a central source of information about which tests and treatments hold low value for certain patients. It provides specific examples, based on medical research, and gives explanations using language that both patients and providers can understand.

“Using such information during a clinic visit, and providing it to a patient after recommending a service or turning down a request, could go a long way toward reducing overuse,” said Preeti Malani, M.D., director of the National Poll on Healthy Aging and a professor of internal medicine who specializes in infectious diseases and geriatrics.

A full report of the findings and methodology is available by clicking here.