Hospitals performed 100,000 unnecessary surgeries in the first year of COVID-19, Lown Institute says

https://www.fiercehealthcare.com/providers/hospitals-performed-100000-surgeries-elderly-2020-lown-institute

U.S. hospitals performed more than 100,000 surgeries on older patients during the first year of the pandemic, according to a new Lown Institute analysis. 

The healthcare think tank relied on Medicare claims data and analyzed eight common low-value procedures. It called the 100,000 procedures unnecessary and potentially harmful in a press release. It found that between March and December 2020, among the most-performed surgeries were coronary stents and back surgeries. 

The procedures either offered little to no clinical benefit, according to the institute, or were more likely to harm patients than help them. 

“You couldn’t go into your local coffee shop, but hospitals brought people in for all kinds of unnecessary procedures,” Vikas Saini, M.D., president of the Lown Institute, said in a statement. “The fact that a pandemic barely slowed things down shows just how deeply entrenched overuse is in American healthcare.”
 
Here is the volume of each procedure analyzed, for a total of 106,474 procedures identified:

1. Stents for stable coronary disease: 45,176
2. Vertebroplasty for osteoporosis: 16,553
3. Hysterectomy for benign disease: 14,455
4. Spinal fusion for back pain: 13,541
5. Inferior vena cava filter: 9,595
6. Carotid endarterectomy: 3,667
7. Renal stent: 1,891
8. Knee arthroscopy: 1,596

Among the “U.S. News & World Report” 20 top-ranked hospitals, all had rates of coronary stent procedures above the national average in what the Lown Institute called “overuse.” Four had at least double the national average, including the Cleveland Clinic, Houston Methodist Hospital, Mt. Sinai and Barnes Jewish Hospital. The procedures and overuse criteria were based on previous Lown research.

“We’ve known for over a decade that we shouldn’t be putting so many stents into patients with stable coronary disease, but we do it anyway,” Saini said. “As a cardiologist, it’s frustrating to see this behavior continue at such high levels, especially during the pandemic.”

In response to the Lown analysis, the American Hospital Association said in a statement Tuesday that delays or cancelations in non-emergency care may have negative outcomes on patients. “Lown may define these services as ‘low value,‘ but they can be of tremendous value to the patients who receive them,” the statement read.

It also pointed to its response to last year’s Lown analysis, which it criticized as being based “on data that are not only incomplete, but also not current.” The organization argued the services surveyed only represent a portion of the care hospitals provide. It added that procedures are determined by physicians based on an evaluation of the patient’s medical needs.