Addressing the overuse-underuse paradox in healthcare.

Area of Science:

• Healthcare Management
• Health Services Research
• Medical Economics

Background:

• Modern healthcare systems exhibit a fundamental contradiction: a simultaneous overuse of low-value services and an underuse of high-value services.
• This imbalance leads to significant negative consequences, including extended wait times, delayed diagnoses and treatments, and poorer patient prognoses.

Purpose of the Study:

• To analyze the healthcare overuse-underuse contradiction within a paradox framework.
• To identify the underlying drivers contributing to both the overuse of ineffective treatments and the underuse of essential, high-value care.

Main Methods:

• Literature review and synthesis of existing studies demonstrating the prevalence of low-value services in healthcare.
• Analysis of healthcare system dynamics through the lens of paradox theory.
• Identification of key factors driving both overuse and underuse of medical services.

Main Results:

• Healthcare systems worldwide provide substantial volumes of services with minimal or no health benefit.
• This provision of low-value care directly competes with resources needed for high-value services, exacerbating system inefficiencies.
• The simultaneous existence of overuse and underuse creates a critical paradox impacting healthcare delivery.

Conclusions:

• Resolving the overuse-underuse paradox is essential for the viability and sustainability of healthcare systems.
• Strategies targeting the drivers of overuse can free up resources to address the underuse of necessary, effective care.
• Mitigating this paradox is crucial for enhancing patient safety, care quality, effectiveness, and overall efficiency.