Cutting back on clinical expenses is critical for medical imaging and other health care specialties, as excess costs lead to issues with profitability. Over time, high costs can impact radiological services and relationships with patients.
A new study, conducted by researchers at NYU Langone Medical Center and published in the Annals of Internal Medicine, highlighted the overuse of cardiac imaging and its contributions to rising costs in health care. According to lead author Joseph Ladapo, Ph.D., this also exposes patients to unnecessary radiation doses that can have harmful effects on their bodies.
Ladapo and his team examined data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey that was collected from 1993 through 2010. They included information on adult patients without coronary heart disease who underwent cardiac stress tests. Over the time period, the number of ambulatory visits in the U.S. that included these exams increased by 50 percent. Tests that were conducted alongside diagnostic imaging grew from 59 percent in 1995 to 87 percent in 2010.
Furthermore, the Ladapo and his colleagues estimated that more than 1 million tests – roughly 34.6 percent of the total – were most likely inappropriate. These exams cost the health care system approximately $500 million annually and may have caused 491 future cases of cancer per year.
Cardiac imaging leads to more tests, no benefits
According to analysis of more than 220 U.S. hospitals, cardiac imaging only leads to further exams that offer little to no benefits to patients and providers. The research, coordinated by Harlan Krumholz, M.D., and his colleagues from the Yale University School of Medicine, was based on data from the PREMIER database from acute-care facilities around the country.
In total, more than 549,000 patient from 224 hospitals were included in the study, and the use of noninvasive imaging ranged from 0.2 percent to 55.7 percent, Medscape reported. When imaging utilization was broken down into quarters, the numbers steadily rose over time, indicating overuse of cardiac exams.
"We found a remarkable variation in the use of imaging, which is an expensive intervention, and its use was strongly linked to what happened to the patient subsequently," said Krumholz, quoted by the source. "The testing cascade has been discussed in other articles, but this is more proof that the more expensive tests you do the more likely you are to pursue additional tests."
It is evident that excessive imaging is an issue within radiology and causes significant financial problems for clinical institutions. With better appropriateness protocols, radiologists could limit overuse of exams that pose health threats to patients.
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Ronny Bachrach
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