Repeat testing could up costs, lead to even more tests

Despite national efforts to curb unnecessary testing, half of older Medicare patients had a repeat heart, lung, stomach or bladder test within three years of an initial test, according to a new Archives of Internal Medicine study, published online yesterday.

Researchers, however, couldn't determine whether the study results suggest physicians are ordering repeat tests or patients are simply developing new problems, Reuters Health reported.

"There is retesting for good reasons, and there is retesting for bad reasons," Nick Fitterman, director of the hospitalist program and chief of staff at Huntington (N.Y.) Hospital, told U.S. News & World Report's HealthDay. "The 800-pound gorilla in the room is that we live in a fee-for-services world; there are financial incentives to do repeat testing," he said.

The studied tests range in price from $200 to more than $1,000, according to Reuters Health.

"If the cardiologist is the one that's ordering and going to interpret it … there probably is a financial incentive to overuse that test," noted Rachel Werner, a health policy researcher from the University of Pennsylvania in Philadelphia.

From 2004 to 2006, Medicare beneficiaries underwent the following tests more than once within three years:

  • 55 percent of echocardiographs
  • 44 percent of imaging stress tests
  • 49 percent of pulmonary function tests
  • 46 percent of chest CT scans
  • 41 percent of cystoscopies
  • 35 percent of upper endoscopies

Patients in metropolitan areas were more likely to have their tests repeated. For instance, patients in Miami tended to have more echocardiograms, but patients in Portland, Ore., had the fewest.

Even though patients may not worry about overdiagnosis (as they would with overmedication), researchers noted that such repeat testing could lead to even more costly tests and possibly unnecessary treatments.

According to the American College of Physicians, unnecessary tests total up to $250 billion a year.

For more information:
- check out the study abstract
- here's the HealthDay article
- read the Reuters Health article

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