Table 2

Healthcare spending of low-value care for 33 healthcare services in the fiscal year 2019

Low-value servicesNarrower definitionBroader definition
Total healthcare spending,* JPY
% of overall healthcare spendingTotal healthcare spending,* JPY
% of overall healthcare spending
Antibiotics prescription for common cold50196.00.01253.30.01
Serum T3 level testing for hypothyroidism9209.60.01209.60.01
Pregabalin prescription for back pain51 52605.00.023473.60.14
Spinal injection for low back pain91733.80.071760.20.07
Oral betamimetics prescription5361.30.00261.30.002
Preoperative pulmonary function testing9119.00.01119.20.01
Preoperative echocardiogram9252.70.01253.80.01
Bone mineral density testing at frequent intervals9 1084.00.003431.00.02
Hypercoagulability testing for patients with deep vein thrombosis9 1021.80.00123.40.001
Intravenous betamimetics for inhibiting preterm labour, >48 hours54101.90.004101.90.004
Preoperative stress testing or stress testing for stable coronary disease9 1049.80.002930.50.04
Preoperative breast MRI5546.50.00249.90.002
Intravenous sivelestat for acute respiratory disease syndrome56 5752.00.00252.00.002
Traction therapy for back pain or neck pain58–600.4<0.0010.5<0.001
Spinal fusion for lumber stenosis11 611038.20.041184.60.05
Endoscopy for dyspepsia for people <55 years or colonoscopy for constipation in people <50 years1140.60.00241.20.002
PTH testing for patients with stages 1–3 chronic kidney disease91.9<0.0012.0<0.001
Electroencephalography for headache96.4<0.00119.70.001
1,25-dihydroxyvitamin D testing in the absence of hypercalcemia or decreased kidney function92.2<0.0012.2<0.001
Vertebroplasty for osteoporotic vertebral fractures9 11459.30.02525.80.02
Inferior vena cava (IVC) filters for the prevention of pulmonary embolism9118.60.01118.60.01
Endotoxin apheresis for sepsis62 63297.10.01297.10.01
Artificial liver support for acute liver failure6410.8<0.00110.8<0.001
PAC in the ICU95.9<0.0015.9<0.001
Arthroscopic surgery for knee osteoarthritis9 1168.50.003288.00.01
Renal angioplasty9 1189.90.00489.90.004
PCI with angioplasty or stent placement for stable coronary disease926.70.0012454.50.10
Intravenous anti-herpes drugs for sudden sensorineural hearing loss650.1<0.0010.3<0.001
Surgery for vesicoureteral reflux118.1<0.0018.1<0.001
Tricyclic antidepressants prescription for children without other psychological disorders66000.1<0.001
Carotid endarterectomy in asymptomatic patients9 110092.10.004
Nasolacrimal probe in infants110000
Electroconvulsive therapy in children110000
Total5708.30.2312 861.30.51
  • *The healthcare spending was calculated based on a fee-for-service method. Healthcare spending on services was multiplied by 20 to approximate the healthcare spending for the entire patient population from 5% samples.

  • ICU, intensive care unit; JPY, Japanese yen (110 JPY=1US$ and 140 JPY=1 British pound); PAC, pulmonary artery catheterisation; PCI, percutaneous coronary intervention; PTH, parathyroid hormone; T3, triiodothyronine.