Quantifying Low-Value Care in Germany: An Observational Study Using Statutory Health Insurance Data From 2018 to 2021
Year: 2024
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: Low-value care refers to medical services whose benefits do not outweigh the costs and potential harm. This study estimates the prevalence, distribution, and associated costs of 24 low-value care services within the German public healthcare system. METHODS: This study was designed as a large-scale retrospective observational study using statutory health insurance data provided by the Techniker Krankenkasse, spanning from 2018 to 2021, covering approximately 11.1 million insured individuals annually. The prevalence of 24 low-value service indicators, which were identified through a systematic review and expert consultations, was calculated. To address uncertainties in distinguishing between appropriate and low-value care, both broad (potential overestimation) and narrow definitions (potential underestimation) were applied to all suitable indicators, providing a range within which the true extent of low-value care is expected to lie. RESULTS: Between 2019 and 2021, 1.6 million patients were identified as having received at least 1 low-value service using the 24 indicators. Of all 10.6 million delivered services (cases) evaluated, on average per year, 1.1 million cases (broad definition) and 0.43 million cases (narrow definition) were classified as low-value care, corresponding to 10.4% and 4.0%, respectively. The costs incurred by the identified services were approximately euros €15.5 million (broad definition) and €9.9 million (narrow definition) annually. CONCLUSIONS: Despite the limitations of German statutory health insurance data, considerable low-value care was found within several of the 24 low-value indicators. The findings highlight the necessity for targeted interventions to mitigate low-value care in Germany, guiding healthcare policy and practice to enhance quality and safety effectively.
Source: Value in Health
Institutions: Jena University Hospital, Technische Universität Berlin, Friedrich Schiller University Jena, Zentralinstitut für die Kassenärztliche Versorgung in der Bundesrepublik Deutschland, University of Cologne, University Hospital Cologne, Association of the Scientific Medical Societies, Techniker Krankenkasse (Germany), Otto-von-Guericke-Universität Magdeburg
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,200
Funder: Gemeinsame Bundesausschuss
Award: G2062581573
OpenAlex ID: W4404566511