News | April 01, 2015

Variations in Use of Physician Preference Items Affect Patient Outcomes and Costs

Study finds medical devices going unused, physicians ordering devices that don’t match patient indications

April 1, 2015 — UHC has released the findings of a new study that evaluated the use of medical devices based on cost and quality outcomes. The goal of the study was to uncover several trends related to high-priced physician preference items (PPIs). Utilization of PPIs — which can account for 30 to 40 percent of a hospital's supply expenses — at 10 academic medical centers, focusing on procedures utilizing orthopedic implants, coronary and peripheral stents and cardiac valves.

The study, begun in 2013, integrated the pilot test of the UHC Supply Cost & Quality Tool, a business intelligence tool designed to help healthcare organizations identify variations in the use of medical devices and their links to costs and patient outcomes. The study identified the following trends:

  • "Custom" does not always mean quality: One organization identified a surgeon who routinely used a customized hip implant for patients undergoing standard, elective total hip replacement. The price tag for the customized implant alone was higher than the average Medicare reimbursement for the entire hospital stay. This physician's patients also had longer hospital stays, on average, and higher readmission rates than those of other physicians.
  • Hidden waste in unused devices: An analysis at one hospital showed that one of its physicians was wasting an average of $600 per hip implant procedure—six times more than other physicians at the hospital—as a result of opened but unused implants.
  • Not all devices match every patient: At one organization, physicians were consistently using hip implant components for older patients that were more advanced than those used for younger patients, counter to published research showing that standard components are more clinically appropriate for less-active patients. The costs of the advanced components were usually at least 25 percent higher than those of standard components.

 

"Our study reinforces that there is a clear need for healthcare 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, CDI operations, product technology, 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."

Following the pilot project, UHC released the Supply Cost & Quality Tool to its membership; UHC members that subscribe to the Clinical Data Base/Resource Manager and SpendLINK are eligible to participate in the tool. 

The case examples in the paper were derived from a very limited data sample from organizations that participated in the Supply Cost & Quality Tool pilot project. UHC plans to develop benchmark data while expanding into additional clinical areas as more participants use the tool.  

For more information: www.uhc.edu

Related Content

Sponsored Content | Videos | Cath Lab | October 24, 2018
Michael Flaherty, M.D., discusses a study published in Circulation Research which finds that use of hemodynamic suppo
Philips Showcases Integrated Solutions for Cardiovascular Care at TCT 2018
News | Cath Lab | September 20, 2018
At the Transcatheter Cardiovascular Therapeutics (TCT) annual meeting, Sept. 21–25 in San Diego, Philips is showcasing...
Sponsored Content | Videos | Cath Lab | September 19, 2018
William O’Neill, M.D., outlines his recent clinical publication of AMICS patients from the Impella Quality (IQ) datab
A complex PCI case to revascularize a chronic total occlusion (CTO) at Henry Ford Hospital in Detroit. Complex PCI and CHIP cases are increasing patient volumes in the cath lab and using a minimally invasive approach in patients who otherwise would have been sent for CABG. Pictured is Khaldoon Alaswad, M.D. DAIC staff photo by Dave Fornell

A complex PCI case to revascularize a chronic total occlusion (CTO) at Henry Ford Hospital in Detroit. Complex PCI and CHIP cases are increasing patient volumes in the cath lab and using a minimally invasive approach in patients who otherwise would have been sent for CABG. Pictured is Khaldoon Alaswad, M.D. (right) who is proctoring a fellow in treating CTOs.

Feature | Cath Lab | September 13, 2018 | Artur Kim, Kamran Zamanian
Coronary artery disease (CAD) is a multifaceted disease that demands various approaches in terms of diagnosis and tre
Videos | Cath Lab | August 13, 2018
Jeffrey Schussler, M.D., FACC, FSCAI, FSCCT, FACP, interventional cardiologist at Baylor Scott White Heart and Vascul
Shockwave Launches Coronary Intravascular Lithotripsy in Europe
News | Cath Lab | May 30, 2018
Shockwave Medical recently announced the European commercial availability of Intravascular Lithotripsy (IVL) for...
FFR software on the GE Centricity CVIS. A trial from the 2018 EuroPCR meeting showed FFR improves long-term outcomes.
News | Cath Lab | May 29, 2018
May 29, 2018 — Ongoing controversy exists regarding the role of percutaneous coronary intervention (PCI) for stable c
Overlay Init