Two New Studies on the High Costs of Unnecessary Care

Two new studies have put a price tag on health care services considered of little benefit to patients. In both reports, researchers raised questions about the role that health care providers play in delivering potentially unnecessary care.

One study examined the cost of care for patients who were taken by ambulance to the most sophisticated, well-equipped trauma centers despite injuries that required far less intensive care. The study looked at where nearly 300,000 patients in the Pacific Northwest, California, Utah, and Colorado received emergency medical care after calling 911. The analysis found that emergency responders delivered one out of three low-risk patients to the most intensive trauma centers, known by the designations level one and level two. The cost of care in level one trauma centers, per average episode, was about $5,600 more than treatment provided by non-trauma hospitals, the researchers wrote. Reducing the number of patients who were treated in level one or level two trauma center, but did not need such intense care, would save about $136.7 million a year across the study's locations.

A second study, published online by the Journal of the American Medical Association Internal Medicine, sought to estimate the cost of critical care that physicians consider “futile.” The cost for one health system totaled $2.6 million for three months, or an average of $4,000 a day. The study authors acknowledged that criteria for futile treatment—in this case, derived from descriptions by 13 doctors—are subjective and patients' families may not agree with them. For their purposes, researchers defined futile care in a half-dozen ways. One definition was care for which the burden was “grossly” greater than any benefit. It was the criterion most frequently cited by doctors who were surveyed for the study. Nonetheless, clinicians continued to provide care they considered futile, but they admitted they didn't know why.