Imaging among the costliest, most prevalent low-value services delivered at children’s hospitals
Imaging is among the costliest and most common low-value healthcare services delivered at U.S. children’s hospitals, according to new research published in JAMA Network Open.
Researchers with several institutions developed a novel calculator to help better understand this concern, pinpointing the most prevalent tests and treatments that offer little benefit to patients. Their analysis unearthed almost $17 million in healthcare costs attributable to 30 different low-value services administered at pediatric institutions in a single year.
Computed tomography for minor head injury was the second most common such service, delivered to nearly 18% of pediatric patients treated in emergency departments. Meanwhile, CT for abdominal pain was the No. 1 priciest low-value service in the ED population, tallying $1.8 in costs in 2019.
“This study found that low-value care was costly, but prevalence varied widely across measured services,” lead author Samantha House, DO, with the Department of Pediatrics at Dartmouth College’s Geisel School of Medicine in Hanover, New Hampshire, and colleagues wrote Dec. 30. “Use of this calculator may aid in prioritization of de-implementation initiatives,” they added.
To reach their conclusions, House et al. conducted a cross-sectional study, developing and applying their tool to information from 49 hospitals included in the Pediatric Health Information System database. Altogether, they identified more than 1 million healthcare encounters in 2019 incurred by 816,000 patients at a median age of 3 years old.
CT for minor head injury was identified as the second costliest services in the ED, tallying $1.5 million in expenditures during the study period. Chest radiography for asthma came in at No. 3 at about $1.1 million. Meanwhile among hospitalized patients, receipt of two or more concurrent antipsychotics was the No. 1 low-value expenditure at $2.4 million, followed by chest X-rays for bronchiolitis (nearly $802,000) or for asthma ($626,000).
House and co-authors also found that delivery of other low-value services was sparse, presenting opportunities to potentially decommission certain metrics.
“As efforts increase to alleviate measurement burden in healthcare, data identifying measures that might be deprioritized are also useful,” the authors advised. “In the ED cohort, head imaging for febrile seizures and blood cultures for bronchiolitis were observed relatively infrequently in eligible encounters.”
You can read more about their work in JAMA here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.