Quantifying low-value services by using routine data from Austrian primary care.

Area of Science:

• Health Services Research
• Public Health Policy
• Primary Care Medicine

Background:

• Initiatives like "Choosing Wisely" to reduce low-value services are absent in Austria.
• Austrian primary care lacks open debates on unnecessary diagnostic tests and ineffective treatments.

Purpose of the Study:

• To identify ineffective or low-value services in Austrian primary care.
• To determine the quantifiability of these services using routine data.
• To estimate the number of affected patients and associated avoidable costs.

Main Methods:

• Identification of low-value care services relevant to Austrian primary care in May 2014.
• Analysis of routine data sets from the Austrian health insurance.
• Focus on the insured population of the Lower Austrian Sickness Fund (n=1,168,433) in 2013.

Main Results:

• 453 potential low-value services were identified in Austrian primary care.
• Only 7.5% (34 services) were quantifiable using routine data.
• These 34 services reached 246,131 beneficiaries, incurring at least €11.38 million in avoidable costs (1.2% of total spending).

Conclusions:

• The study highlights the potential and limitations of claims-based measures for identifying low-value care.
• An inadequate diagnostic coding system in Austrian primary care hindered a comprehensive assessment.
• Findings underscore the significant financial burden of low-value services in primary care.