Since the President Obama's landmark Affordable Care Act and health care policy loomed over the debates of the last United States Presidential election, much discussion has been spent over how to make the health care industry more affordable and less wasteful. One recent report found that, if the United States' health care industry was its own country, it would the fifth-largest economy in the world.
A new study has shed some light on waste in the industry. The recent study published in the Archives of Internal Medicine found that many seniors are given repeat tests and, while some repeat tests are administered for good reason, some are certainly a demonstration of the waste of a $2.8 trillion system.
The study, conducted by H. Gilbert Welch, Kevin J. Hayes, and Carol Frost, examined a 5 percent random sample of Medicare beneficiaries who lived in one of the 50 major American cities. The study examined the testing patterns of 743,478 patients who had one of the following six tests performed between January 1, 2004 and December 31, 2006: echocardiography, imaging stress tests, pulmonary function tests, chest computed tomography, cystoscopies, and upper endoscopies. These tests were examined specifically because they are well-known among doctors and there is no agreed-upon consensus on the practice of repeat testing. In order to put things into context, the study authors also looked at two tests that are expected to be performed routinely: eye exams and screening mammography.
The researchers found that 79 and 72 percent of patients have repeat eye exams and mammograms within three years, respectively, as expected. For the six tests, they found that 35 percent of upper endoscopies were repeated, the lowest rate of repeating of the bunch; 55 percent of echocardiographies were repeated.
Researchers found that there was a significant difference of geography in the instance of repeat testing. For example, 66 percent of the six exams in Miami were repeated. By contrast, 47 percent of exams were retested in Portland. This finding led researchers to wonder whether some doctors have a practice of performing routine testing, even if the repeat tests are not necessary.
Of course, sometimes repeat tests are necessary, like if the original tests are botched. Often, however, tests are readministered so that doctors can avoid litigation or to increase profits.
There is no health disadvantage for repeat testing, but the practice increases the risk of incidental detection and of overdiagnosis.
Published by Medicaldaily.com