The U.S. healthcare system is stepping up efforts to encourage physicians and patients to choose cost-efficient care. Today, 17 medical specialty societies identified 90 more tests and treatments that they say are overused or inappropriate, bringing the total to 135, the American Board of Internal Medicine announced.
Additions to the "Choosing Wisely" campaign, which pinpoints the major sources of unnecessary care, include:
- Elective induction of labor or C-section deliveries before 39 weeks: By reducing early deliveries without medical cause, hospitals can cut costs without compromising care, given new research that shows hospitals waste billions of dollars on unnecessary cesarean sections.
- Automatic use of CT scans to evaluate children who visit hospital emergency departments with head injuries: Studies have associated CT scanning with radiation exposure that could significantly increase the risk for cancer. Moreover, researchers recently determined repeat CT scans are unnecessary for patients with mild head trauma if the condition is unchanged or they have improved neurologically.
- Delayed palliative care for a patient with serious illness who has physical, psychological, social or spiritual distress because they are pursuing disease-directed treatment: Patients who receive palliative services have increased satisfaction and better quality outcomes, according to recent research. Palliative care programs also offer hospitals a return on investment. For instance, University of Rochester (N.Y.) Medical Center's palliative care intervention saved 1,400 ICU patient days at an average of $450 a day.
However, a misalignment between some cost-sharing strategies and evidence-based guidelines has caused physicians and patients to struggle to 'choose wisely' in high-value healthcare, according to an October 2012 article in the Journal of the American Medical Association.