Identifying, measuring and reducing low-value care in the context of health system performance assessment

The State of Health in the EU Companion Report 2019 highlighted that health systems show varying capacities to identify low-value care. While achieving value-based healthcare and the optimal use of resources are recognised as important goals, there is no consensus on which indicators should be used to identify and measure low-value care, particularly in the context of health system performance assessment (HSPA), and which measures and policies can facilitate reductions in its use. Hence, there is substantial scope for better understanding of the system perspective on low-value care and further developing low-value care indicators within HSPA. This identification is anticipated to inform cross-country learning to maximise value for patients within and across health systems. As a result, the Expert Group on HSPA worked during 2023-2024 to address the gap in information about low-value care indicators that can be used in European Union (EU) Member States (and Norway) and how they can be leveraged to help reduce the use of low-value care. Following a review of the literature, a survey was conducted between December 2023 and February 2024 among members of the Expert Group. The purpose of the survey was to arrive at a comprehensive definition for low-value care, to identify indicators used by European countries for measuring low-value care within HSPA and highlight methodological obstacles, and to identify current and new solutions to reduce the use of low-value care. Twenty experts from 17 EU Member States and Norway responded to the survey