Actor Michael J. Fox once said, “Medical science has proven time and again that when the resources are provided, great progress in the treatment, cure, and prevention of disease can occur.” While more often than not his statement rings true, sometimes our resources and medical advances may also be too widely used and perhaps overused, or sometimes even unnecessarily used.
The results of two studies published in this week’s JAMA reported that there may be an overabundance in the use of blood transfusions during cardiac surgery. In one study, Hajjar and colleagues found that stricter oversight on the amount of blood transfusions performed in cardiac surgery patients may actually reduce the rates of death and illness.
In fact, the researchers reported that patients who received fewer red blood cell (RBC) transfusions showed similar results compared to those who were transfused more liberally.
Likewise, Bennett-Guerrero and colleagues reported a high level of hospital variance for the rates of RBC, fresh frozen-plasma and platelet transfusions in CABG patients; however, they found similar rates of death. They concluded that this could suggest that several blood transfusions in this patient population may be unnecessary.
Additionally, a study published this week in Circulation showed that attempting to repair lower extremity peripheral artery disease (PAD) may actually fuel costs and stir future hospitalizations and revascularizations.
Over 20 percent of both asymptomatic and symptomatic PAD patients experienced at least one vascular-related hospitalization during the two-year study period. The authors reported that hospitalization costs associated with patients who underwent lower limb amputation and who underwent revascularization were $10,430 and $11,693, respectively.
Meanwhile, a study published Oct. 11 in the Archives of Internal Medicine found that Medicare beneficiaries with heart failure (HF) repeatedly use healthcare resources in the last six months of life. In fact, Unroe et al found that over 80 percent of the almost 300,000 patients assessed were hospitalized in the last six months prior to death.
Additionally, costs to Medicare skyrocketed almost 30 percent between 2000 and 2007 and the number of patients admitted to the intensive care unit increased by almost 8 percent. The researchers concluded that these rising medical costs could be associated with the increase in medical testing and procedures and said that an analysis of resource use should be undertaken.
While new advances in medical technology may help to nourish patient care, they may also depreciate it, if the proper guidelines and research are not in place. While technology to repair PAD or heart failure may be valuable in the long run, not using resources properly or using them excessively may hinder care and incur costs.
On these topics or others, please feel free to contact me.