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Using the evidence-based medicine and evidence-based management to minimise overuse and maximise quality in healthcare: a hybrid perspective
  1. Edris Hasanpoor1,
  2. Ali Janati2,
  3. Morteza Arab-Zozani2,
  4. Elaheh Haghgoshayie1,2
  1. 1 Department of Healthcare Management, Maragheh University of Medical Sciences, Maragheh, Iran
  2. 2 Department of Health Services Management, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
  1. Correspondence to Dr Elaheh Haghgoshayie, Department of Healthcare Management, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran; ezd_ehm2010{at}yahoo.com

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Introduction

The main preference is addressing the expenditure of healthcare, which increases in the majority of developed countries. Overuse and unessential healthcare are one of the most amazing areas to aim is described as services that provide small or no advantage to patients or healthcare centres. Today, if physicians routinely provided medical services consistent with the latest scientific evidence, all patients could obtain more benefit from implementing clinical guidelines. Therefore, two parts are essential to progress the quality of healthcare: improvement of evidence-based medicine (EBMed), which reinforces the clinicians’ skills and identifies the clinical actions leading to better medical services, and evidence-based management (EBMgt), which recognises the hospital strategies, organisation, and management practices to provide evidence-based medical services. An evidence-based approach has been promoted as a systematic mechanism of the best available evidence to management and medicine decision-making process, addressed at improving the performance of health services organisations.1–4

High expenditure on medical care costs without cost-effectiveness considerations may cause absolutely loss. Many factors involve overusing, including technology development, providers’ payment mechanisms that increase utilisation of medical care, creeping, patients’ values and legal considerations of patients.5–7 Overuse in medical care can be categorised into three main parts: overuse of testing, which can lead to overdiagnosis of disease. Overuse of testing causes false-positive results and over diagnosis; overtreatment, which includes providing treatment; and treatment of overdiagnosed disease.8 Negative test findings do not appear to genuinely reassure patients. Both physicians and patients are responsible for exceeding overuse of healthcare, and both sections are experiencing the outcomes. This joint responsibility between physician and patient may translate into improved patient satisfaction and patient care. In overtreatment, patients were placed at a risk of adverse events with increasing both medical treatments and systemic …

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