{"doi":"10.1093/haschl/qxaf225","title":"Low-cost, high-volume healthcare services contribute the most to low-value care spending in Japan","abstract":"Abstract Introduction High-income countries face the urgent task of reducing healthcare spending incurred by low-value care. However, evidence is limited as to whether high-cost or low-cost low-value care services contribute more to total unnecessary healthcare spending, especially outside the United States. Methods Using a claims database covering all age groups in Japan from April 2022 to March 2023 (approximately 2 million beneficiaries, or 2% of the total population), we examined 52 low-value care services using two versions of claims-based measures with different sensitivities and specificities (narrower and broader definitions). Results We identified 3.1 million (narrower) to 3.7 million (broader) episodes of low-value care services, accounting for 42.6-67.2 million USD, or 0.7%-1.0% of total healthcare spending. In the narrower definition, lower-cost services (<80 USD per service) contributed to virtually all episodes of low-value care and 67% of total unnecessary healthcare spending—far exceeding the 33% attributed to the higher-cost services (≥80 USD). Conclusion This finding suggests that compared with focusing solely on higher-cost low-value care services, targeting the reduction of frequently performed, lower-cost low-value care services may be a more effective and efficient strategy for reducing wasteful spending.","journal":"Health Affairs Scholar","year":2025,"id":582699,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6514,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":542306,"name":"John N. Mafi","orcid":"0000-0002-0322-7636","position":1,"is_corresponding":false},{"id":1494689,"name":"Tsuguya Fukui","orcid":"0009-0009-2835-8892","position":2,"is_corresponding":false},{"id":1494690,"name":"Yuya Kimura","orcid":"0000-0003-1649-0596","position":3,"is_corresponding":false},{"id":1494691,"name":"Daiki Kobayashi","orcid":"0000-0002-3641-2088","position":4,"is_corresponding":false},{"id":1494692,"name":"Sara Odawara","orcid":"0000-0001-6626-7195","position":5,"is_corresponding":false},{"id":1494693,"name":"Kazuhiro Abe","orcid":"0000-0001-6197-4659","position":6,"is_corresponding":false},{"id":1304370,"name":"Rei Goto","orcid":"0000-0002-7484-4957","position":7,"is_corresponding":false},{"id":335103,"name":"Yusuke Tsugawa","orcid":"0000-0002-1937-4833","position":8,"is_corresponding":false},{"id":512976,"name":"Atsushi Miyawaki","orcid":"0000-0001-6126-1464","position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-19T02:58:59.653747Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}