Waste in health care spending: A scoping review

ABSTRACT

In most developed countries, the sustained increase in health care spending has concentrated the efforts of governments and international organizations to identify sources and implement strategies to mitigate waste in health spending, thus contributing to efficiency and equity in health systems.

This research aimed to account for evidence on sources of wasteful health spending according to domains proposed by Berwick and Hackbarth (2012). A systematic exploratory review was conducted on search engines, PUBMED, Web of Science, and the Center for Review and Dissemination (CRD) of the University of York and the NHS. The search strategy focused on quantitative studies that were original articles on the six Berwick and Hackbarth domains.

The proliferation of this type of study, especially in developed countries, clearly expresses a global concern for the generation of scientific evidence, which allows the design and implementation of public policies and strategies to mitigate and control excessive health spending. Middle-income countries should urgently incorporate cost-effective clinical practices to improve resource allocation.

Therefore, it is urgent to generate empirical evidence on inefficient, excessive, or wasteful health spending, which allows the design and implementation of public policies to achieve better efficiency and equity in the medium term.

KEYWORDS:

• Health care
• spending
• wasteful
• low value
• overtreatment
• efficiency
• equity

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Pedro Olivares-Tirado

Pedro Olivares-Tirado MD, MBA, MSc in Health Economics, York University, UK. PhD of Philosophy in Human Care of Science, University of Tsukuba, Japan. Associate Professor in the Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Visiting professor Mental Health Program, School of Public Health, University of Chile.

Rosendo Zanga

Rosendo Zanga, Professor of Language, Bachelor of Arts, Master of Public Health Universidad de Chile. PhD (4th year) Social Sciences, The Latin American Faculty of Social Sciences (FLACSO). Adjunct professor of the System Policy and Management program of the School of Public Health of the University of Chile.