AHA President: U.S. healthcare must improve efficiency

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In a speech he admitted was “more political and social than scientific” American Heart Association President Raymond Gibbons, MD, FACC, outlined key issues that he feels must be addressed to bring about the best possible future in healthcare. Gibbons address opened proceedings earlier this week at the American Heart Association Scientific Sessions in Chicago.

On core area, he said, is making healthcare efficiency a much higher priority. Gibbons believes that “increased spending does not produce better care” citing five states – Hawaii, Utah, New Hampshire, Oregon, and South Dakota – all that have the lowest healthcare expenditures but that also have some of the highest quality marks.

As for imaging, Gibbons said the rise in spending for stress cardiac images in this country is another example of inefficiency. “I doubt this 6 percent yearly increase in Medicare points is efficient,” he said, “It dwarfs the rate of increase of cardiac catheterization, revascularization, or acute MI.”

As a further example, Gibbons revealed some previously unpublished preliminary data from a study evaluating the ACC/ASNC appropriateness criteria for SPECT profusion. The study looked at studies ordered by Mayo Clinic physicians that reportedly had nothing to gain financially from the tests they ordered or the equipment to be used, he said. Of the 296 studies evaluated, 11 percent were ordered for reasons not listed in the criteria, 10 percent for “inappropriate” criteria, and 13 percent of the cases involved “uncertain” criteria. Improving efficiency in this particular area requires that cardiologists “strive to decrease the number of tests in these last two categories,” Gibbons said.