One might think that something consuming up to one-third of our nation’s $2.3 trillion in health care spending would be easy to identify. But part of the challenge of reducing waste in health care – defined as spending that could be eliminated without reducing the quality of patient care – is to find where it is, why and how much. And although many policy experts and organizations have published well-regarded, specific studies of waste, until now there has been no system-wide collection of waste evidence.

The New England Healthcare Institute (NEHI) recently tackled this issue in How Many More Studies Will It Take? A Collection of Evidence That Our Health Care System Can Do Better. We gathered a detailed collection of nearly 500 peer-reviewed studies from health care literature between 1998 and March of 2006, a period when interest in the quality of care exploded following the conclusions of the IOM’s National Roundtable on Health Care Quality that “serious and widespread” problems of overuse, underuse and misuse are harming “very large numbers of Americans” throughout the country. The compendium spans a multitude of examples of waste in health care, from the overuse of emergency rooms to adverse events including medication errors.

Knowing where health care waste is, why it exists and how many dollars are wasted are prerequisites for removing it from the system, but until now, we have not had a rigorous compilation of this type of evidence. Taken together, the evidence demonstrates that our health care system can and should do better – and challenges each sector to confront the physical and financial harm of wasteful, inefficient and poor-quality care.

Wendy Everett, President, The New England Healthcare Institute