Little progress seen in reducing unnecessary ambulatory care

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"There has been little change in the delivery of inappropriate ambulatory care in the past decade," concluded a team of researchers from Mount Sinai School of Medicine in New York City, whose work was published online this week in the Journal of the American Medical Association.

According to the study of data from two large national ambulatory patient databases comparing changes in 22 quality indicators from 1999 to 2009, physicians have gotten better about providing more of the types of care that had been considered underused, such as the use of beta-blockers and aspirin for certain heart conditions, Medpage Today reported.

During the same decade, however, only two forms of overused care decreased, while unnecessary screening for prostate cancer in older men increased.

Overall, six of nine underuse quality indicators improved, while physicians cut back on two of 11 unnecessary and potentially harmful types of services. Eight indicators showed no change. Given the need to stem the spiraling healthcare costs in the United States, the authors concluded that such results were concerning.

However, Amir Qaseem, director of clinical policy at the American College of Physicians, told Reuters that addressing misuse and overuse of therapies isn't about getting rid of services that are too expensive, but requires physicians to better evaluate what current tests and treatments may offer little value for certain patients.

To learn more:
- read the article from Reuters
- see the story from Medpage Today
- check out the abstract from JAMA

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