Overuse in the inpatient sector
How many patients undergo unnecessary surgery in Switzerland?
Factsheet
- Schools involved School of Health Professions
- Institute(s) Institute of Health Economics and Health Policy
- Strategic thematic field Thematic field "Caring Society"
- Funding organisation SNSF
- Duration (planned) 01.01.2024 - 31.12.2026
- Head of project Prof. Dr. Tobias Benjamin Müller
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Project staff
Jana Franziska Bilger
Dr. Ana Cecilia Quiroga Gutierrez
Prof. Dr. Tobias Benjamin Müller - Keywords Overuse; low-value care; hospital care
Situation
40-50% of patients are not treated in accordance with recent medical guidelines and many procedures are performed unnecessarily. In addition to the inefficient use of resources, overuse can lead to unnecessary suffering for patients.
Course of action
We identify a catalog of medical treatments that should not be performed according to clinical guidelines and medical literature and can be measured in routine data. Based on this, we measure the extent and trends of medical overuse in the inpatient sector in Switzerland.
Result
Over the 11-year study period, an estimated 296,000 hospitalized patients received at least one low-value care service. Indication-based rates varied across indicators, with the highest rates ob-served for spinal fusion in lumbar stenosis (27.2%) and hysterectomy for benign gynecological dis-ease (25.3%). Temporal trends were unfavorable: 52% of indicators showed no meaningful change between 2012-2022, 33% increased by at least one percentage point, and only 15% showed a decline. Patient-level regression analyses showed that planned admission was the strongest predictor of low-value care receipt (+11.3 percentage points vs. non-planned admission), followed by private or semi-private ward status (+2.5 percentage points vs. general ward). Older age and higher comorbidity burden were associated with lower probabilities of receiving low-value care.
