It’s important to note that some of the discrepancy may be due to generally poorer health condition among older people than their younger counterparts. However, it’s also important to note potential financial factors that influence the kinds of decisions hospitals, doctors and surgeons make.
Medicare patients can help prevent wasting their own time and help the Medicare system save money by being informed about common procedures and practices suspected of overuse on Medicare patients. This does not, however, mean that patients should outright refuse any of the following. Rather, seeking out a second opinion or finding a health facility that is not associated with suspected over-performance of these practices may be in order.
Opioid pain-killers are a dangerous game. As overall use of these drugs has increased, so has the rate of addiction, overdose, cross-over to heroin use and death. A study published in the British Medical Journal found that, among 1.2 million Medicare patients prescribed an opioid whose records they reviewed, 35% had obtained prescriptions for such drugs from more than one medical professional. Those receiving prescriptions from more than one source had a three times higher rate of hospital admission for opioid-related problems, including overdose that led to death. See more on this at www.boston.com.
The reason why this occurs with such high frequency among Medicare patients is not known. Part of the problem could simply be a lack of proper care coordination between different medical professionals. Patients should know the full dangers associated with pain-killers, and make sure everyone involved in their health care knows what medications they take.
Complex Spinal Fusions
Spinal fusion is a very common form of back surgery involving the fusion of vertebrae to eliminate painful instability. A few years ago, research revealed that the rate of complex spinal fusions – involving the fusion of more than two vertebrae – increased 15-fold among Medicare recipients between 2002 and 2007. There was no solid evidence in favor of the procedure over other, less expensive and less invasive measures corresponding to the increase in its performance. Complex spinal fusions come with high risks, particularly for older adults.
Hospitals get reimbursed at much higher rates for fusion than for less invasive procedures, and surgeons stand to make a pretty penny off it themselves. For more on this, read the article at online.wsj.com.
Unnecessary Screenings and Imaging Tests
Researchers from the Harvard Medical School found that somewhere between 25% and 42% of Medicare patients in their sample received at least one “wasteful” diagnostic procedure, depending on how narrowly they defined “wasteful.” Procedures among those that are generally considered to be used inappropriately include lower back MRI, CT scans of the sinuses and cervical cancer screenings for women over 65. See more on this study at www.sciencedaily.com.
A movement has emerged to help patients and practitioners avoid health care waste called Choosing Wisely. Their website contains lists of questionable procedures and more information about them. Find it at www.choosingwisely.org.