“Underuse” refers to patients not getting the care that research shows is beneficial. Many patients are not receiving care recommended by such authoritative sources as the U.S. Preventive Service Task Force, the Agency for Healthcare Quality and Research, physician specialty groups and others.
In a landmark RAND study only 46.3% of patients received necessary and recommended care. This underuse applied to recommended preventive, chronic and acute care alike. Proper preventive treatment was neglected for a diverse set of potential health problems. For example, among elderly patients only 64% received pneumococcal vaccine. Experts estimate that 10,000 deaths a year could be prevented by appropriate use of these vaccinations.
Persons with high blood pressure are at increased risk for heat disease, stroke and death, yet, according to the Rand study, patients with hypertension received only 65% of the recommended care. The study also found that only slightly more than half of recommended treatment was provided for asthma, and significantly less than 40% of recommended care was received for pneumonia, sexually transmitted disease, peptic ulcer and hip fracture.
Regular Pap smears have been shown to decrease mortality from cervical cancer by 20–to-60 percent. Despite recommendations that all women between the ages of 21 and 65 receive a Pap smear screen for cervical cancer every three years, about 11 percent of women do not get screened. At the same time, a majority of women are screened for cervical cancer more often than recommended.
In another example, just 40 percent of adults age 40 and over with diagnosed diabetes receive all three recommended services for diabetics, including regular blood tests, an annual dilated eye examination and a foot exam. Such tests are intended to detect complications that can cause blindness or lead to amputations.
Even hospitals considered among the best in the country routinely fail to give beta-blockers within 24 hours of a heart attack despite evidence that rapid treatment can prevent heart damage or death.
In a landmark RAND study only 46.3% of patients received necessary and recommended care. This underuse applied to recommended preventive, chronic and acute care alike. Proper preventive treatment was neglected for a diverse set of potential health problems. For example, among elderly patients only 64% received pneumococcal vaccine. Experts estimate that 10,000 deaths a year could be prevented by appropriate use of these vaccinations.
Persons with high blood pressure are at increased risk for heat disease, stroke and death, yet, according to the Rand study, patients with hypertension received only 65% of the recommended care. The study also found that only slightly more than half of recommended treatment was provided for asthma, and significantly less than 40% of recommended care was received for pneumonia, sexually transmitted disease, peptic ulcer and hip fracture.
Regular Pap smears have been shown to decrease mortality from cervical cancer by 20–to-60 percent. Despite recommendations that all women between the ages of 21 and 65 receive a Pap smear screen for cervical cancer every three years, about 11 percent of women do not get screened. At the same time, a majority of women are screened for cervical cancer more often than recommended.
In another example, just 40 percent of adults age 40 and over with diagnosed diabetes receive all three recommended services for diabetics, including regular blood tests, an annual dilated eye examination and a foot exam. Such tests are intended to detect complications that can cause blindness or lead to amputations.
Even hospitals considered among the best in the country routinely fail to give beta-blockers within 24 hours of a heart attack despite evidence that rapid treatment can prevent heart damage or death.