EBM adherence and health care costs

Health care policy discussions these days share a common theme: health care expenditures in the U.S. are excessive; if doctors would adhere to research evidence (or if they had more research findings to adhere to) costs would go down, right? Wrong, according to the best data we have on quality metrics, published in NEJM:

We also classified indicators according to the problem with quality that was deemed most likely to occur, and we found greater problems with underuse (46.3 percent of participants did not receive recommended care [95 percent confidence interval, 45.8 to 46.8]) than with overuse (11.3 percent of participants received care that was not recommended and was potentially harmful [95 percent confidence interval, 10.2 to 12.4]).

According to this landmark study, with recommendations derived from research as the benchmark, doctors underutilize far more than they overutilize. It’ll take some really creative design tweaking by government policy makers to produce research findings to drive their agenda of lowering costs.