The Lown Institute, a health care think tank, found more than a million tests and procedures performed in hospitals on Medicare patients from 2016-2018 met established criteria for overuse.
“These results are if anything the low end of the estimate,” said Dr. Vikas Saini, president of the Lown Institute. “It speaks to the power of habit, weak penetration of actual science and certainly a lot of prominent financial incentives for hospitals and doctors without any counter-balancing information that patients could use to push back.”
More
It’s time to consider primary care a “common good” akin to public education and shore up the foundation of the pandemic-battered U.S. health system, report says.
More
The merger between Virginia Mason and CHI Franciscan health system in the Seattle area raises questions about maintaining quality and not raising prices.
More
"Like so much in American healthcare, the practice outran the evidence: there have been randomized trials that have shown that vertebroplasty for osteoporosis in the elderly is not an effective therapy," Saini said. "New people who are getting into the field may not do it, but people who always did it, they're always going to say, 'Well, I don't trust that evidence, it works for me.' There's a lot of that in medicine."
Saini said it will take doctors to personally decide to no longer order unnecessary tests and procedures.
"But hospitals are also often willing participants because some of this needs fancy, expensive equipment," Saini said. "So when the hospital incurs a capital cost, you get a situation where now you got to pay off that investment, and I think it's a sort of mutual back scratching that happens."
The Institute wants to see doctors and hospital administrators take a hard look at what procedures they do first as the pandemic recedes in much of the country and elective surgeries begin again. Saini wants to see unnecessary tests integrated into safety and quality rankings, instead of just including measures like complications and infections.
"Whether or not you really even need this care ought to be one of the fundamental pillars of what quality means," Saini said. "But there has not been a national framework in which, for example, the Joint Commission on Accreditation, or NQF, or any of these folks, really made this a fundamental plank of their mission."
More
Houston boasts of being home to the Texas Medical Center, the world's biggest medical complex. Yet Houston's medical community also holds a distinction that's hardly boast-worthy: It's the worst major metro area in Texas for unnecessary health care tests and procedures.
"Overuse in American hospitals is a pervasive problem that needs to be addressed," Dr. Vikas Saini, president of the Lown Institute, says in a news release. "Hospitals want to do better, and these objective measures of performance can help them move forward."
More
Every 80 seconds, a hospital in the U.S. delivers a low-value test or procedure to an older adult, putting hundreds of thousands at risk of harm, according to a new analysis from the Lown Institute, a health care think tank. The Institute today released a ranking of over 3,100 U.S. hospitals that examines success at avoiding the use of tests and procedures that offer little to no clinical benefit.
More
Using a 100 percent sample of 2013–16 Medicare fee-for-service claims data, we examined whether hospital and health system ownership of physician practices was associated with changes in site of care and Medicare reimbursement rates for ten common diagnostic imaging and laboratory services.
More
Chronic pain from covid can linger for months after patients appear to recover from the disease.
More
Overall Medicare spending increases for inpatient care are being driven more by rising volumes of highly reimbursed services than by growth in payments per se.
More
Although cesarean delivery can be lifesaving for both the mother and neonate, the increase in cesarean delivery rates has not been associated with any demonstrable improvements in maternal or neonatal morbidity or mortality.
More
While professional guidelines recommend antidepressants for back pain, researchers point out the lack of evidence for their usefulness.
More
We're excited to share our new research on hospital overuse just published in JAMA Network Open!
More
The adoption of expensive medical technology by individual providers to compete for patients is one of the reasons that U.S. healthcare is the world’s most expensive on a per capita basis. Many experts see proton beam as a classic example of an American-style medical arms race.
“There’s real harm in spending money on something that’s not better and is more expensive. That harm is a hospital not investing in something else that could improve its community or improve the health of more patients,” Shannon Brownlee, special adviser to the president of the Lown Institute, wrote in a recent blog post about proton beam therapy.
More
The U.S. government invested $800 million in plasma when the country was desperate for Covid-19 treatments. A year later, the program has fizzled.
More
Clinicians should know the rough probability of a patient having a certain disease based on their symptoms and test results. Yet health care practitioners are not as good as you might expect at predicting patients' disease risk, a new study finds.
More
Over the past 7 years, many randomized clinical trials (RCTs) have evaluated vitamin D supplementation for improving primary or secondary outcomes of cardiovascular disease, cancer, diabetes, depression, bone health, and falls, necessitating a reevaluation of whether screening for vitamin D insufficiency might be worthwhile.
More
In this systematic scoping review of 334 published studies in children and adolescents, convincing evidence was found that ADHD is overdiagnosed in children and adolescents. For individuals with milder symptoms in particular, the harms associated with an ADHD diagnosis may often outweigh the benefits.
More
A survey of more than 2,200 hospitals finds that despite progress in reducing C-section rates, there's a long way to go.
More
The ACP guidelines apply to inpatients and outpatients who have uncomplicated infections.
More
In the early 1950s, Dr. Bernard Lown made what he called his greatest contribution to medicine, saving 100,000 lives each year and changing the standard of care for heart attack patients forever--simply by getting people out of bed and into a chair. How did this happen? Watch the video and read the blog below to hear the story in Dr. Lown's own words.
More
