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Evidence to Practice
September 2018

Calculating Health Care Waste in Washington State: First, Do No Harm

Author Affiliations
  • 1Cardiovascular Division, Washington University School of Medicine in St Louis, St Louis, Missouri
  • 2Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
JAMA Intern Med. 2018;178(9):1262-1263. doi:10.1001/jamainternmed.2018.3516

The Washington Health Alliance recently published a report documenting the frequency of 47 low-value care practices.1

Low-value services are defined as medical tests and procedures that have been shown to provide little clinical benefit and have the potential to cause harm.1 Harm may be categorized as physical (a medical intervention that causes ≥1 negative consequences for the patient including infection, overexposure to radiation through unnecessary imaging, or an unneeded or duplicative test), emotional (worry and anxiety caused by a medical intervention such as being prescribed tests that are known to produce high rates of false-positive results), or financial. Harm is particularly troublesome when it is the result of health care that was unnecessary.

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