Research: The Power of Evidence

Weeding out Waste

One might think that something consuming up to one-third of our nation's $2.3 trillion in health care spending would be easy to identify.  But part of the challenge of reducing waste in health care -- defined as spending that could be eliminated without reducing the quality of patient care -- is to find where it is, why and how much.

NEHI knew that a multitude of specific examples of waste had been identified, but were buried in the pages of disparate reports for nearly a decade.  Our mission was formidable, but clear: To focus needed attention on waste, we needed to unearth and compile these examples into a single collection. 

First, we collected nearly 500 peer-reviewed studies released between 1998 and March of 2006, a period of high interest in quality of care following the conclusion of the IOM that "serious and widespread problems of overuse, underuse and misuse are harming very large numbers of Americans."  The resulting report, How Many More Studies Will It Take?, includes wide-ranging examples of waste, from the overuse of emergency rooms to adverse events including medication errors, and includes an annotated bibliography compiled and published by RAND researchers.

Next, in a second report called Waste and Inefficiency in the U.S. Health Care System, we quantified our findings by the magnitude of waste, presented analysis of its root causes -- and proposed appropriate actions to successfully eliminate it.  Finally, in our third report, Improving Physician Adherence to Clinical Practice Guidelines, we examined a specific area of waste: the variation between recommended care and actual care delivered, and presented recommendations to help bridge this gap.

Together, this research presents the strongest case to date for the need to address waste.  Now the evidence is clearer than ever: Each sector in the health care system must confront the physical and financial harm of wasteful, inefficient and poor-quality care.