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Overuse has become a major issue of healthcare quality, safety, and
sustainability around the world. In this Element, the authors
discuss concepts, terminology, and the history of concerns. They
show how interventions to address overuse target multiple drivers.
They highlight successes and promising approaches, but also
challenges in generating and using evidence about overuse. They
emphasise that different stakeholder perceptions of value must be
recognised. System-level efforts to restrict access to services
have created tensions between stakeholder groups and stimulated
politicised debates about rationing. They argue for clear
articulation of priorities, problem definition, mechanisms for
interventions, and areas of uncertainty. Policy-makers should
prioritise transparency, be alert to inequalities as they seek to
reduce overuse, and consider how to balance controlling use with
enabling clinicians to respond to individual circumstances. The
complexity of the drivers and possible solutions to overuse require
the use of multiple research methods, including social science
studies. This title is also available as Open Access on Cambridge
Core.
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