Variations in the way physicians use medical devices have a significant effect on patient outcomes and costs, a new study found.
An analysis by the University HealthSystem Consortium (PDF) examining so-called physician-preference items at 10 academic medical centers found costs differed for cases involving such items as orthopedic implants, coronary and peripheral stents, and cardiac valves.
The cost of procedures such as hip replacement were higher at one hospital based on a physician's preference to use a more expensive, customized implant even when a cheaper option would have been medically appropriate. Use of the customized implant also resulted in longer patient stays and higher readmission rates for those patients compared with other physicians' patients.
A physician at another facility included in the analysis was found to have wasted an average of $600 per hip implant procedure because of simply opening devices that were never used.
“Our study reinforces that there is a clear need for health care organizations to have an integrated view of supply costs and patient outcomes in resource-intensive areas, such as orthopedic and cardiovascular care," said Mike Oinonen, senior director for product technology at UHC. "By leveraging data from UHC's supply chain and clinical databases, along with utilization data from their clinical systems, the study participants identified significant opportunities to reduce clinical variation, strengthen contract negotiations with suppliers, improve product selection, and minimize product waste.”
The study began in 2013 as part of a pilot program designed to assess the links between variations in medical-device usage and the cost and patient outcomes associated with their use.
Controlling costs affected by physician-preference items has been a focus for a growing number of providers over the past decade, which can account for up to 40% of a hospital's supply expenses, according to a 2013 report by the Healthcare Financial Management Association.
Examples included for the study came from data samples from organizations that participated in UHC's Supply Cost & Quality Tool pilot project, a business intelligence tool the organization designed to help healthcare providers identify variations in the use of medical devices and their links to costs and patient outcomes.