Financial Waste is Patient Harm: Reducing Wasteful Healthcare Spending Increases Safety and Health.

Abstract

Wasteful healthcare spending has more than economic costs-there are clinical costs as well. Waste increases out-of-pocket costs, delays necessary care, and worsens outcomes. We argue that, while most quality frameworks do not consider this patient harm, they should. Financial waste is clinically on par with medical errors and adverse events, as overtreatment and low-value care injure patients, care coordination failures lead to preventable complications and death, pricing failures cause delayed and complicated care, and low-value procedures cause complications. We reviewed the literature to tie financial waste, toxicity, and pollution to patient harm across 4 domains: care delivery, care coordination, overtreatment or low-value care, and pricing failure. Even with insurance, healthcare is unaffordable for most Americans, leading to delayed care and lower quality of life. Solutions exist, and specialty care platforms have successfully employed strategies to offset patient harm. Including financial harm in quality frameworks increases the urgency to address financial waste.