5 low-value emergency procedures to avoid

Healthcare providers could significantly reduce costs if they eschew five low-value, often unnecessary emergency medicine procedures, according to a new study published in JAMA Internal Medicine.

The researchers, led by Jeremiah D. Schuur, M.D., of Brigham and Women's Hospital in Boston, assembled a panel of technical experts, who brainstormed low-value procedures and then ranked them according to cost, benefit and actionability. After the ranking process, the researchers polled the panel for the final ranking. The top five procedures were:

  • Post-traumatic computed tomography (CT) of the cervical spine for patients who are not high-risk;

  • CT of the head for mild traumatic head injury patients who are not high-risk;

  • Use of CT to diagnose pulmonary embolism without first assessing patient risk;

  • Anticoagulation studies for patients who do not have hemorrhage or suspected clotting disorder; and

  • Magnetic resonance imaging (MRI) of the lumbar spine for lower back pain among patients who do not have high-risk features.

Not only are these procedures unnecessary expenses, they may actively harm patients in some cases, according to Daily RX. The average cost of an emergency room visit has nearly tripled since 2003, rising from $560 to $1,354, according to the article.

"Our project piloted a method that EDs (emergency departments) can use to identify actionable targets of overuse; we identified clinical actions that were of low value, within clinician control, and for which consensus existed among ED health care clinicians," Schuur and his team said in a statement. "Developing and addressing a top-five list is a first step to addressing the critical issue of the value of emergency care."

With healthcare's increased emphasis on quality over quantity, unnecessary care is a widespread concern. In January, the American Association of Critical-Care Nurses released a list of five recommendations for avoiding unnecessary critical care procedures, FierceHealthcare previously reported.

To learn more:
- here's the study abstract
- read the article
- check out the statement

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