Saturday, June 18, 2011

Ah, Unsurprising

The New York Times has an excellent article on double scanning: when a patient is given a CT scan...then given another in the same day. If you've been paying attention to this blog, you know that the value of one of these scans is somewhat ambiguous, so it may come as no surprise that getting two in the same day is not a good idea--from a cost perspective, or, of course, a health one (one CT scan = 350 chest X-rays, so, uh...a lot of radiation there). Basically many of the trends you've heard about the health care system are present in the article. It's a question of incentives, first (hospitals get to bill twice); a question of culture and geography, second. (Geographically--and this isn't a surprise--Massachusetts scores best in not giving patients double scans; Oklahoma scores worst.) Culturally:
The Medicare agency believes hospitals can and should do more to change physician behavior. “Hospitals will say, ‘Wait, we don’t order tests, why are you measuring us?’ ” said Dr. Michael Rapp, who directs the Quality Measurement and Health Assessment Group for the federal agency. But, he added, “Hospitals certainly have the ability to put in policies and to monitor what’s happening.”
Correct. It's not exactly a significant source of revenue for hospitals, so the culture of throwing-the-entire-arsenal at the problem tends to reign.

And, of course, like many health care problems, reducing the amount of care here actually means better care and better health for the patient, insofar as receiving unnecessary blasts of radiation tends to injure one's health.

No comments:

Post a Comment