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Researchers at University of Tsukuba analyzed the provision of low-value care in primary care settings. It was found that most of this care was provided by a small number of physicians. Among these, older physicians, physicians who were not board certified, and those having high patient volumes were more likely to provide low-value care.

Tsukuba, Japan—Low-value care refers to health care services that have little or no net clinical benefit to the patient. Reducing such care is essential for avoiding unnecessary examinations and treatments, reducing healthcare costs, and reallocating limited medical resources--both financial and human--to more effective services. Despite the significance of this issue, the characteristics of the physicians who are provide such care more frequently have not been thoroughly investigated.

Using records of approximately 2.5 million patients from a large-scale clinic claim database, the researchers analyzed the provision of 10 types of low-value care service provided in primary care. They found that approximately 1 in 10 patients received at least one low-value care instance annually, with an overall rate of 17.2 episodes per 100 patients per year.

Further, nearly half of all low-value care services were provided by 10% of the physicians, where older physicians, physicians who were not board certified, and physicians having higher patient volumes being more likely to provide low-value care. Regional variation was also observed, where rates were higher in western Japan. These findings suggest that policy interventions that target a small number of certain types of physicians providing large quantities of low-value care may be more effective and efficient than interventions targeting all physicians uniformly.

Reducing the frequency of low-value and ineffective medical interventions is important to ensure the sustainability of healthcare systems while maintaining patient safety and the quality of care. The insights that are gained from this study can help inform future policy and improvements in clinical practice to optimize healthcare delivery.

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This study was supported by grants from the Health Care Science Institute (to Dr Miyawaki), the Japan Society for the Promotion of Science (grant 24K02701 to Dr Miyawaki), and Gregory Annenberg Weingarten GRoW @ Annenberg (to Dr Tsugawa).

Original Paper

Title of original paper:

Primary Care Physician Characteristics and Low-Value Care Provision in Japan

Journal:

JAMA Health Forum

DOI:

10.1001/jamahealthforum.2025.1430

Correspondence

Associate Professor MIYAWAKI Atsushi
Institute of Medicine, University of Tsukuba

Related Link

Institute of Medicine