Medical Overuse in the Iranian Healthcare System: A Systematic Scoping Review and Practical Recommendations for Decreasing Medical Overuse During Unexpected COVID-19 Pandemic Opportunity.
COVID-19
Iran
healthcare system
medical overuse
Journal
Risk management and healthcare policy
ISSN: 1179-1594
Titre abrégé: Risk Manag Healthc Policy
Pays: England
ID NLM: 101566264
Informations de publication
Date de publication:
2020
2020
Historique:
received:
15
05
2020
accepted:
15
07
2020
entrez:
28
8
2020
pubmed:
28
8
2020
medline:
28
8
2020
Statut:
epublish
Résumé
To perform an inclusive search for original studies that report medical overuse in the Iranian healthcare system and discovering the area of overuse. A systematic search of the literature is conducted in bibliographic databases including PubMed, Embase, Scopus, Web of Sciences, Cochrane and Scientific Information Database using a comprehensive search strategy without time limit until the end of 2018, updated by 1 July 2020, accomplished by reference tracking, author contacting and expert consultation to identify studies on the overuse of medical care. We reviewed 4124 published articles based on predetermined inclusion criteria. The author's consensus included a total of 41 articles. Of these, 32 were in English and 9 in Farsi, published between 1975-2019. The result categorized into two distinct clinical areas: treatment (18 articles) and diagnostic (23 articles) services. Almost all of the studies only described the magnitude of unnecessary overuse. Unnecessary overuse of antibiotics, MRI, and CT-scan were the most reported topics. The ranges of their overuse proportion were as follows: antibiotic (31 to 97%); MRI (33 to 88%), and CT-scan (19 to 50%). Our review showed, even so, the magnitude of unnecessary overuse of medical services is high but there are only a few interventional studies in clinical and administrative level for finding effective methods for decreasing these unnecessary services. Researchers should be encouraged to conducting interventional studies. We suggest the ministry of health to use the golden opportunity of COVID-19 epidemic for designing Iran national policy and action plan for controlling and preventing unnecessary healthcare services and including a section for "Interventional Research" in the action plan.
Identifiants
pubmed: 32848487
doi: 10.2147/RMHP.S262908
pii: 262908
pmc: PMC7429239
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
1103-1110Informations de copyright
© 2020 Pezeshki et al.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest in this work.
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