Overutilization

Unnecessary health care (overutilization, overuse, or overtreatment) is healthcare provided with a higher volume or cost than is appropriate. In the United States, where health care costs are the highest as a percentage of GDP, overuse is the predominant factor in its expense, accounting for about a third of healthcare spending in the US ($750 billion out of $2.6 trillion).

Factors that drive overuse include paying healthcare providers more to do more and covering patients' costs by a third-party (public or private insurance) payer. Such factors leave both doctors and patients with no incentive to restrain health care prices or use.

Overtreatment, in the strict sense, may refer to unnecessary medical interventions, including treatment of a self-limited condition (overdiagnosis) or to extensive treatment for a condition that requires only limited treatment.

A forerunner of the term was what Jack Wennberg called unwarranted variation, different rates of treatments based upon where people lived, not clinical rationale. He had discovered that in studies that began in 1967 and were published in the 1970s and the 1980s: "The basic premise-that medicine was driven by science and by physicians capable of making clinical decisions based on well-established fact and theory-was simply incompatible with the data we saw. It was immediately apparent that suppliers were more important in driving demand than had been previously realized."

In 2008, bioethicist Ezekiel J. Emanuel and health economist Victor R. Fuchs defined unnecessary healthcare as "overutilization," healthcare provided with a higher volume or cost than is appropriate.

In 2009 two physicians wrote in an editorial, that unnecessary care was "defined as services which show no demonstrable benefit to patients" and might represent 30% of U.S. medical care.

They referred to a 2003 study on regional variations in Medicare spending, which found, "Medicare enrollees in higher-spending regions receive more care than those in lower-spending regions, but do not have better health outcomes or satisfaction with care."

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