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A conceptual framework for understanding and reducing overuse by primary care providers.

Adam A Powell1, Hanna E Bloomfield, Diana J Burgess

  • 11Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA.

Medical Care Research and Review : MCRR
|August 7, 2013
PubMed
Summary

Primary care providers sometimes overuse health services. This study proposes a framework based on the theory of planned behavior to understand and reduce this overuse, guiding future research and interventions.

Keywords:
inappropriate careoverusephysician decision makingtheory of planned behaviortheory of reasoned action

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Area of Science:

  • Health Services Research
  • Behavioral Science
  • Primary Care Medicine

Background:

  • Primary care providers (PCPs) often recommend or prescribe health services that offer minimal patient benefit.
  • Understanding and reducing PCP overuse of services is crucial for healthcare efficiency and patient well-being.
  • Existing interventions lack a theoretically grounded framework, hindering prediction of success.

Purpose of the Study:

  • To present a theoretical framework for understanding and reducing PCP overuse of health services.
  • To guide future research and intervention development aimed at optimizing healthcare resource allocation.
  • To identify key provider beliefs and factors influencing the decision-making process for service recommendation.

Main Methods:

  • The study utilizes the theory of planned behavior (TPB) as a foundational model.
  • It outlines categories of PCP beliefs that shape intentions to assess service appropriateness.
  • It proposes factors influencing the translation of assessment intentions into appropriate recommendations.

Main Results:

  • The proposed TPB-based framework categorizes PCP beliefs influencing intentions to assess service appropriateness.
  • It identifies potential moderators affecting the link between assessment intentions and actual service recommendations.
  • Commonly used interventions for overuse are reviewed within this theoretical context.

Conclusions:

  • The TPB framework offers a structured approach to studying PCP overuse.
  • It provides a basis for developing targeted interventions to improve the appropriateness of recommended health services.
  • Further research is needed to validate the framework and test its effectiveness in practice.