The latest issue of the HARC eBulletin, released today by the Sax Institute, highlights that a growing number of researchers and healthcare leaders are questioning the necessity of many tests and treatments.

More health care does not necessarily mean better health, as Robert Brook, a respected elder-statesman of health systems research, from the Rand Corporation recently argued in the Journal of the American Medical Association.

He cited evidence suggesting that increasing the affordability and the amount of care provided to patients will NOT lead to improved population level health outcomes because there is so much inappropriate care being given to patients.

At first glance this might seem contrary to the general assumption that more health care at cheaper prices will result in improved patient outcomes.

The reason “more health care” does not result in “better health care” is because even if health care was delivered on demand, a significant minority of patients would still receive inappropriate and unnecessary care (estimated at 40% of patients in the USA).

For example, Brook cites a British study where they checked whether patients who underwent surgery for a coronary angiography and bypass surgery really needed it — and the answer was only one in two patients did.

In Australia we don’t really have any good data on appropriate care (mainly because it is hard to measure) but it’s fair to assume that our experience would be similar to the US and the UK.

Reducing unnecessary care will require the policy community to rely on the clinical and health service management communities as the main drivers of change. In turn, policy makers, clinicians and managers will have to work with the research community to ensure we have a useful evidence base to guide work in this area. This has be a key component of any health system reform.

The HARC (Healthy Ageing Research Cluster) eBulletin, is produced by the Sax Institute partnership with the NSW Clinical Excellence Commission and the Greater Metropolitan Clinical Taskforce.