Hospitals continued to perform these eight overused procedures in 2020, analysis of Medicare data shows
BOSTON, MA: The nation’s hospitals performed more than 100,000 unnecessary and potentially harmful procedures on older patients between March and December 2020, according to a new analysis by the Lown Institute, a healthcare think tank. Coronary stents and back surgeries were among the most-performed unnecessary procedures over this period.
The analysis of Medicare claims data shows that thousands of vulnerable patients were admitted to U.S. hospitals during the height of the pandemic, before COVID-19 vaccines were approved, for procedures that offer little to no clinical benefit or were more likely to harm patients than help them. The analysis of eight unnecessary and potentially harmful procedures is the first to measure rates of overuse at U.S. hospitals during the COVID-19 pandemic.
“You couldn’t go into your local coffee shop, but hospitals brought people in for all kinds of unnecessary procedures,” said Vikas Saini, MD, president of the Lown Institute. “The fact that a pandemic barely slowed things down shows just how deeply entrenched overuse is in American healthcare.”
Number of procedures, Mar-Dec 2020
Volume of eight low-value procedures in U.S. hospitals per Medicare claims
Stents for stable coronary disease: 45,176
Vertebroplasty for osteoporosis: 16,553
Hysterectomy for benign disease: 14,455
Spinal fusion for back pain: 13,541
Inferior vena cava filter: 9,595
Carotid endarterectomy: 3,667
Renal stent: 1,891
Knee arthroscopy: 1,596
Total unnecessary procedures identified: 106,474
Coronary stents were the most overused by volume of all the procedures. Across the country, approximately one in five met criteria for overuse, including at some of the nation’s most well-regarded hospitals. For example, among the U.S. News top 20 hospitals, all had rates of coronary stent overuse above the national average, and four had rates at least double that: Cleveland Clinic (44%), Houston Methodist Hospital (44%), Mt. Sinai (42%), and Barnes Jewish Hospital (42%).
“We’ve known for over a decade that we shouldn’t be putting so many stents into patients with stable coronary disease, but we do it anyway,” said Dr. Saini. “As a cardiologist, it’s frustrating to see this behavior continue at such high levels, especially during the pandemic.”
Methodology
For this analysis, the Lown Institute used data from the 100% Medicare claims database from January – December 2020 to evaluate volume of overuse for eight common low-value procedures. Procedures and overuse criteria were based on our previously published research into measurement of low-value care at hospitals.
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SEE ALSO:
U.S. hospitals with the highest rates of unnecessary stents (2020 data)
Top hospitals for avoiding overuse (2018-2020 data)
State ranking for avoiding overuse (2018-2020 data)
Panel Discussion: Join us May 17, 2022 at 1 p.m. ET for a live event as we discuss our latest overuse findings, featuring the Lown Institute’s Vikas Saini, Shannon Brownlee, and Kelsey Chalmers:
About the Lown Institute
Founded in 1973 by Nobel Peace Prize winner Bernard Lown, MD, developer of the defibrillator and cardioverter, the Lown Institute believes that a radically better system of health is possible and generates bold ideas towards that goal. The Lown Institute Hospitals Index for Social Responsibility is a signature project of the Institute and features measures never used before like racial inclusivity, avoidance of overuse, and pay equity.
Contact
Aaron Toleos, Lown Institute, (978) 821-4620, atoleos@lowninstitute.org