Table 3 Comparison of Low-Value Care in Direct versus Purchased Care

1

Population-based screening for vitamin D deficiency

1605

3189

386,450

306,462

0.42

1.04

0.48 (0.45–0.51)*

2

Skin prick test or IgE blood tests in children with atopic dermatitis

88

29

136

6975

64.71

0.42

3.23 (2.10–4.97)*

3

Testing for RSV in children with bronchiolitis

331

25

1876

2998

17.64

0.83

21.60 (14.29–32.65)*

4

Blood tests in children with a simple febrile seizure

22

2

180

326

12.22

0.61

24.44 (5.49–108.82)*

5

Cervical cancer screening w/ HPV test or Papanicolaou test in children

39

721

39,269

48,531

0.10

1.49

0.07 (0.05–0.09)*

6

Testing for group A streptococcal pharyngitis in children aged < 3 years

3772

4241

65,830

29,065

5.73

14.59

0.36 (0.34–0.38)*

7

Face or nose radiograph in children with head or face trauma

207

219

8892

13,910

2.33

1.57

1.98 (1.62–2.42)*

8

Ultrasound in children with cryptorchidism

45

63

282

310

15.96

20.32

0.68 (0.44–1.06)

9

Sinus imaging in children with acute sinusitis

12

40

3480

20,976

0.34

0.19

1.99 (1.03–3.81)*

10

Neuroimaging in children with a simple febrile seizure

4

5

180

326

2.22

1.53

1.42 (0.37–5.42)

11

Neuroimaging in children with headache

175

997

3084

10,632

5.67

9.38

0.59 (0.50–0.69)*

12

Cough and cold medications in children aged < 6 y

–

–

–

–

–

–

–

13

Oral antibiotics for acute upper respiratory infections

3235

9830

50,148

54,391

6.45

18.07

0.35 (0.34–0.37)*

14

Oral antibiotics for acute OME

1219

3475

3300

8419

36.94

41.28

0.82 (0.75–0.89)*

15

Oral antibiotics for acute otitis externa

333

589

4069

6092

8.18

9.67

0.82 (0.72–0.95)*

16

Oral antibiotics after tonsillectomy

13

211

677

1815

1.92

11.63

0.14 (0.08–0.25)*

17

Oral antibiotics for bronchiolitis

186

648

1876

2998

9.91

21.61

0.48 (0.40–0.58)*

18

Oral corticosteroids for bronchiolitis

276

684

1876

2998

14.71

22.82

0.62 (0.53–0.72)*

19

Short-acting β-agonists for bronchiolitis

795

1158

1876

2998

42.38

38.63

1.16 (1.03–1.31)*

20

Acid blockers for infants with uncomplicated gastroesophageal reflux

–

–

–

–

–

–

–