Racial inequity in low value care

Decreasing low value care (health services where potential harms exceed potential benefits) improves patient outcomes and is the target of multiple initiatives across the world, including the Choosing Wisely campaign.1 Most research and implementation efforts have focused on areas of overuse that seem common, without examining potential inequities in the receipt of those services. If there are differences in who receives low value care, then it could inform existing health equity gaps.

While it seems clear that Black patients receive fewer evidence based, recommended services than White patients,23 whether they also receive fewer low value services has remained uncertain.45 In a linked study in The BMJ (doi:10.1136/bmj-2023-074908), Ganguli and colleagues aimed to characterize differences associated with race in the receipt of 40 low value services.6 This retrospective cohort study of nearly 10 million Medicare beneficiaries (aged 65 or older) across 595 health systems in the United States found that Black patients had higher rates of low value acute diagnostic tests and lower rates of low value screening …