{"title":"Addressing the overuse-underuse paradox in healthcare.","authors":"Bjørn Hofmann","doi":"10.1007/s11019-025-10287-2","DOIUrl":null,"url":null,"abstract":"<p><p>There is a basic contradiction in modern healthcare: while there is an urgent need for more resources to provide documented effective care in many health systems, the same systems provide extensive services that are reported to have little or no effect on people's health. This induces long wait times, delayed diagnoses and treatments, poorer prognosis, and worse outcomes. That is, a wide range of studies have demonstrated health care systems to provide large volumes of low-value services while not being able to provide much needed high-value services. This contradiction between simultaneous overuse and underuse can be analysed in a paradox framework. Moreover, identifying the drivers of overuse and underuse can help us develop strategies to curb the problem, its implications, and free resources for reducing underuse. Hence, resolving the overuse-underuse paradox is crucial for the viability of healthcare systems: for the safety, quality, effectiveness, efficiency, and sustainability of care.</p>","PeriodicalId":47449,"journal":{"name":"Medicine Health Care and Philosophy","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicine Health Care and Philosophy","FirstCategoryId":"98","ListUrlMain":"https://doi.org/10.1007/s11019-025-10287-2","RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ETHICS","Score":null,"Total":0}
引用次数: 0
Abstract
There is a basic contradiction in modern healthcare: while there is an urgent need for more resources to provide documented effective care in many health systems, the same systems provide extensive services that are reported to have little or no effect on people's health. This induces long wait times, delayed diagnoses and treatments, poorer prognosis, and worse outcomes. That is, a wide range of studies have demonstrated health care systems to provide large volumes of low-value services while not being able to provide much needed high-value services. This contradiction between simultaneous overuse and underuse can be analysed in a paradox framework. Moreover, identifying the drivers of overuse and underuse can help us develop strategies to curb the problem, its implications, and free resources for reducing underuse. Hence, resolving the overuse-underuse paradox is crucial for the viability of healthcare systems: for the safety, quality, effectiveness, efficiency, and sustainability of care.
期刊介绍：
Medicine, Health Care and Philosophy: A European Journal is the official journal of the European Society for Philosophy of Medicine and Health Care. It provides a forum for international exchange of research data, theories, reports and opinions in bioethics and philosophy of medicine. The journal promotes interdisciplinary studies, and stimulates philosophical analysis centered on a common object of reflection: health care, the human effort to deal with disease, illness, death as well as health, well-being and life. Particular attention is paid to developing contributions from all European countries, and to making accessible scientific work and reports on the practice of health care ethics, from all nations, cultures and language areas in Europe.
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