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Overuse and Underuse

…overuse is the provision of medical services for no benefit or for which harms outweigh benefits.

Source: Korenstein D, Falk R, Howell EA, Bishop T, Keyhani S (2012) Less is more. Overuse of healthcare services in the United States. An understudied problem. Arch Intern Med 172(2): 171-179.

Example of the term in use:

Direct measurement of overuse through documentation of delivery of inappropriate services is challenging given the difficulty of defining appropriate care for patients with individual preferences and needs; overuse can also be measured indirectly through examination of unwarranted geographical variations in prevalence of procedures and care intensity. Despite the challenges, the high prevalence of overuse is well documented in high-income countries across a wide range of services and is increasingly recognised in low-income countries.

Underuse:

… underuse is the lack of provision of necessary care (eg no aspirin prescribed after myocardial infarction), …

Source: Korenstein D, Falk R, Howell EA, Bishop T, Keyhani S (2012) Less is more. Overuse of healthcare services in the United States. An understudied problem. Arch Intern Med 172(2): 171-179.

Example of the term in use:

Underuse … is common and responsible for substantial suffering, disability, and loss of life worldwide. Underuse occurs at every point along the treatment continuum, from populations lacking access to health care to inadequate supply of medical resources and labour, slow or partial uptake of innovations, and patients not accessing or declining them. The extent of underuse for different interventions varies by country, and is documented in countries of high, middle, and low-income, and across different types of health-care systems, payment models, and health services.

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