According to a new study published in the Archives of Internal Medicine, Medicare patients go through repeat imaging procedures more often than necessary.
The study looked at a 5% random sample of living Medicare beneficiaries who underwent any of the following commonly performed diagnostic tests/exams between 2004 and 2006: upper endoscopy, cystoscopy, both echocardiography and stress echocardiography, chest CT, nuclear imaging stress, mammography, eye exams, and pulmonary function tests. Of the 750,000 patients involved, researchers from the Dartmouth Institute for Health Policy and Clinical Practice found that between 33% and 50% patients were receiving these diagnostic tests too often. Moreover, patients living in metropolitan areas were found to undergo repeat testing more often than those who were not residing in said areas.
It should be noted that while repeat tests were warranted in some cases, the researchers did not look into the diagnostic history of every subject as part of this study. For that reason, we do not have exact figures that specify what portion of the tests were necessary versus those that were not. Regardless of those tallies, the 33-50% figure is still high enough to deserve attention.
The outcomes of this research have many implications, with the greatest area of concern likely being how these repeat testing procedures impact the state of ongoing patient health. In their analysis, the study’s author, Dr. H. Gilbert Welch, and his team stressed the need for hospital practices to place greater focus on following clinical guidelines. Other physicians suggest that these goals might prove achievable through the use of an electronic clinical guidance system. Because unnecessary repeat testing can lead to over-diagnosing patients or additional findings that are unrelated to the original purpose of their exam, the end result of such practices is often higher procedural costs. So far, electronic guidance systems have proven helpful to this decision-making process and a welcome assist with cost containment efforts.
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