Thread: Study: Too many patients are getting angiograms

Could this be one reason healthcare costs are going up?



Study: Too many patients are getting angiograms



12:00 AM CST on Thursday, March 11, 2010

Malcolm Ritter, The Associated Press

NEW YORK – A troublingly high number of U.S. patients who are given angiograms to check for heart disease turn out not to have a significant problem, according to the latest study to suggest Americans get an excess of medical tests.



The researchers said the findings indicate that doctors must do better in determining which patients should be subjected to the cost and risks of angiograms. The tests carry a small but real risk – less than 1 percent – of causing strokes or heart attacks, and also entail radiation exposure.



"We can do better. There is no doubt in my mind," said Dr. Ralph Brindis of the University of California, San Francisco, one of the study's authors.



Every year in the U.S., more than a million people get angiograms, in which a thin tube is inserted in the arm or groin and threaded to the heart to check for blocked arteries that could lead to a heart attack. Dye is injected through the tube to make blockages show up on X-rays.



Angiograms are often given to patients who might be having heart attacks or have symptoms that suggest serious blockages. They are also sometimes done on people who have less clear-cut symptoms, like shortness of breath, or no symptoms but some risky traits like high cholesterol and an abnormal result on another heart test. This group accounts for about 20 to 30 percent of angiogram cases.



In the study, nearly two-thirds of the patients in this second group were found to have no serious blockages.



The researchers could not establish why so few proved to have heart disease. But Dr. Harlan Krumholz, a Yale cardiologist and health outcomes researcher unconnected to the study, said he thinks the problem arises because doctors are afraid of missing something and also of getting sued.



"We fear doing too little," he said. "I think that we developed a culture where people feel that doing more and knowing more is always the proper course. What that does is sometimes lead us to overuse."



Cost is also a concern. On average, Medicare pays about $1,400 for an outpatient angiogram and about $3,000 for the procedure in a hospital.



Researchers said more study is needed to sort out how to better select patients for an angiogram. For now, experts suggest patients in the category studied question their doctors about the need for the test and the risks and alternatives.

[quote name='freckles' date='11 March 2010 - 06:53 PM' timestamp='1268362424' post='128201']

a Yale cardiologist and health outcomes researcher unconnected to the study, said he thinks the problem arises because doctors are afraid of missing something and also of getting sued.[/b]



"We fear doing too little," he said. "I think that we developed a culture where people feel that doing more and knowing more is always the proper course. What that does is sometimes lead us to overuse."[/quote]



Sorry, the Obots have declared fear of malpractice is a non-issue because thats what the anointed one has

declared.

Doing some quick ballpark math, that's about 400 million dollars wasted every year in defensive medical proceedures... a lotta money that could be slashed by tort reform in just this one area of medicine.



I guess that is inconsequencial money when one has bigger fish to fry.

It's an exploratory procedure. Is it a waste to those whose results show no damage? Possibly, but the peace of mind is probably worth it. For those who are saved because the procedure detected life threatening situations, I'd say it is worth every penny.



Dad had it done a few years ago and it revealed that his heart was fine. The fella in the next bed was lucky to have his done when he did. He had 90% blockage in two areas and needed immediate surgery. The cardiologist said that another 24 hours and he would have died. I guess it depends on your attitude as to what is a waste and what isn't.

[quote name='Gypsy' date='11 March 2010 - 10:58 PM' timestamp='1268366313' post='128228']

It's an exploratory procedure. Is it a waste to those whose results show no damage? Possibly, but the peace of mind is probably worth it. For those who are saved because the procedure detected life threatening situations, I'd say it is worth every penny.



Dad had it done a few years ago and it revealed that his heart was fine. The fella in the next bed was lucky to have his done when he did. He had 90% blockage in two areas and needed immediate surgery. The cardiologist said that another 24 hours and he would have died. I guess it depends on your attitude as to what is a waste and what isn't.

[/quote]



The guy was obviously in there for a reason...I'd guess 90% blockage would have some serious and visible symptoms....the article suggested that approximately 300 thousand have the procedure done with little to no symptoms...just getting a "check up", and only a third of those are found to have any potential problems...that leaves 200 thousand, or about 400 million health care dollars spent to aleviate fears of getting sued because "something was missed"

[quote name='Gypsy' date='11 March 2010 - 07:58 PM' timestamp='1268366313' post='128228']

It's an exploratory procedure. Is it a waste to those whose results show no damage? Possibly, but the peace of mind is probably worth it. For those who are saved because the procedure detected life threatening situations, I'd say it is worth every penny.



Dad had it done a few years ago and it revealed that his heart was fine. The fella in the next bed was lucky to have his done when he did. He had 90% blockage in two areas and needed immediate surgery. The cardiologist said that another 24 hours and he would have died. I guess it depends on your attitude as to what is a waste and what isn't.

[/quote]



And it's exactly the kind of thing the government bureaucrats will be cutting back on under new standards

to save costs.



http://healthit.hhs.gov/portal/server.pt



In the "American Recovery and Reinvestment Act." they already set up the system to control everyone's medical

records, I'm sure somewhere in the current HC bill they expand powers to include dictating practices.

[quote name='webrockk' date='11 March 2010 - 11:13 PM' timestamp='1268367236' post='128233']

The guy was obviously in there for a reason...I'd guess 90% blockage would have some serious and visible symptoms....the article suggested that approximately 300 thousand have the procedure done with little to no symptoms...just getting a "check up", and only a third of those are found to have any potential problems...that leaves 200 thousand, or about 400 million health care dollars spent to aleviate fears of getting sued because "something was missed"

[/quote]



His symptoms were the same as Dad's ... chest pains. Dad was cleared the other guy wasn't.

[quote name='bla bla' date='11 March 2010 - 11:15 PM' timestamp='1268367318' post='128234']

And it's exactly the kind of thing the government bureaucrats will be cutting back on under new standards

to save costs.



http://healthit.hhs.gov/portal/server.pt



In the "American Recovery and Reinvestment Act." they already set up the system to control everyone's medical

records, I'm sure somewhere in the current HC bill they expand powers to include dictating practices.

[/quote]



You are probably right.

[quote name='Disappointed not surprised' date='11 March 2010 - 11:27 PM' timestamp='1268368079' post='128239']

I can see the NYT headlines now:



Obamacare Administrator Releases New Guidelines for Angiograms

-- Dateline January 2, 2011 Washington, D.C.



After careful study Rahm Emanuel's brother has decided that the guy in the bed next to Gypsy's Dad should go just go ahead and die. He was old anyway, and a UAW worker needs that hospital bed for a combination gastric bypass surgery and to have his man-boobs reduced. The Obamacare guidelines place a high priority on self esteem (page 2425 of the reconciliation), and the UAW's Cadilac plan (paid for with tax dollars) authorizes surgery that supports self esteem if you meet the corrrect age/sex/race/religious/political affiliation condtions (the Barney Frank apendage to page 2312 of the reconciliation).

[/quote]





Ok and this was necessary why?