Studies
find worrying over- and underuse of medicine worldwide
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[January 09, 2017]
By Kate Kelland
LONDON - Up to 70 percent of hysterectomies
in the United States, a quarter of knee replacements in Spain and more
than half the antibiotics prescribed in China are inappropriate,
overused healthcare, researchers said on Monday.
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Experts who carried out a series of studies across the world found
that medicine and healthcare are routinely both over- and underused,
causing avoidable harm and suffering and wasting precious resources.
The studies, commissioned by The Lancet journal and conducted by 27
international specialists, also found rates of Caesarian section
deliveries are soaring - often in women who do not need them - while
the simple use of steroids to prevent premature births has lagged
for 40 years.
"A common tragedy in both wealthy and poor countries is the use of
expensive and sometimes ineffective technology while low-cost
effective interventions are neglected," the experts wrote in a
statement about their findings.
The World Health Organization estimates that 6.2 million excess
C-sections are performed each year - 50 percent of them in Brazil
and China alone.
Vikas Saini, one of the lead authors of the study series and
president of the U.S. Lown Institute in Boston, said factors driving
the global failure to the right level of care include "greed,
competing interests and poor information", which he said combine to
create "an ecosystem of poor healthcare delivery."
Co-lead researcher Shannon Brownlee added: "Patients and citizens
need to understand what's at stake here if their health systems fail
to address these twin problems. In the U.S., we are wasting billions
of dollars that should be devoted to improving the nation's health."
The study series analyzed the scope, causes and consequences of
underuse and overuse of healthcare around the world. It found that
both can occur in the same country, the same organization or health
facility, and even afflict the same patient.
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The researchers noted that a study in China found 57 percent of
patients received inappropriate antibiotics; that inappropriate
hysterectomies in the United States range from 16 to 70 percent; and
inappropriate total knee replacement rates were 26 percent in Spain
and 34 percent in the United States.
Rates of inappropriate hysterectomies were 20 percent in Taiwan and
13 percent in Switzerland, they found.
Underuse leaves patients "vulnerable to avoidable disease and
suffering" the researchers said, while overuse causes avoidable
harms from tests or treatments at the same time as wasting resources
better spent on much-needed services.
(Editing by Raissa Kasolowsky)
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