Plain Language Summary

This study explores the prevalence and costs of low-value medical services in Germany, using data from the statutory health insurance system between 2018 and 2021. Low-value care refers to services where the benefits do not outweigh the costs or potential harm. This research identified 24 indicators of such care within the German healthcare system, revealing that annually, between 4.0% and 10.4% of medical cases could be categorized as low-value care. This translates to approximately 0.43 to 1.1 million cases affecting 0.34 to 0.71 million patients per year.

The study found that these services incurred notable costs in the ambulatory sector, ranging from €9.9 to €15.5 million each year. The most prevalent low-value services included antibiotics for respiratory infections, testing thyroid hormone levels for hypothyroidism, and the use of benzodiazepines in older patients. These 3 indicators accounted for the majority of low-value care cases, highlighting areas where targeted interventions could be most effective.

Age and sex also influenced the distribution of low-value care. A large portion of inappropriate medical services was provided to middle-aged individuals, with women receiving more low-value diagnostic tests compared to men. Moreover, general practitioners referred about two-thirds of these low-value services, although this varied across different medical procedures.

This study's findings offer crucial insights for patients, healthcare providers, and policy makers. For patients, understanding the prevalence of low-value care can inform better healthcare decisions. Healthcare providers can use this information to improve service quality and focus on more effective treatments. Policy makers can leverage the study's data to implement targeted strategies aimed at reducing low-value care, potentially redirecting resources to higher-value services.

While the study provides a comprehensive overview of low-value care in Germany, it acknowledges limitations such as the absence of detailed data on symptoms and disease severity, which may affect the accuracy of estimates. Moreover, the onset of the COVID-19 pandemic during the study period might have influenced healthcare delivery patterns.

Overall, this study emphasizes the need for ongoing monitoring and evaluation of medical practices to enhance healthcare quality and efficiency, guiding future efforts to minimize unnecessary medical interventions in Germany.

^{Note: This content was created with assistance from artificial intelligence (AI) and has been reviewed and edited by ISPOR staff. For more information or for inquiries on ISPOR’s AI policy, click here or contact us at info@ispor.org.}