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Top overused primary care activities top $6 billion

Testing bone density in women under 65, ordering unnecessary complete blood cell counts, antibiotics for sore throats, prescribing brand statins. See what non-recommended activities cost a year.
Written by Janet Fang, Contributor

Less is more…

Earlier this summer, the Good Stewardship Working Group, a project by the National Physicians Alliance, presented the top 5 clinical activities that needed improvement in 3 primary care specialties: pediatrics, internal medicine, and family medicine.

These were considered overused activities common in primary care but offer little benefit to patients (and sometimes cause serious harm). Specifically, they are top examples of the “most egregious causes of waste.”

This week, a team of doctors examined the frequency and costs associated with these actions (because there were some overlap between the 3 specialties, the final list was actually 12). Some findings:

  • Non-recommended activities in primary care account for an approximate annual cost of $6.76 billion.
  • Ordering a complete blood cell count for a general medical exam was the most prevalent activity, costing $32.7 million.
  • The most expensive practice was prescribing brand name instead of generic statins to lower cholesterol – like Lipitor or Crestor. This resulted in excess expenditures of $5.8 billion per year, or 86% of the costs of the top 5 lists.
  • Bone density testing in women younger than 65 years was the least prevalent activity, but it accounted for $527 million in costs.
  • Papanicolaou (pap) tests for patients younger than 21 years cost about $47 million.
  • Imaging for back pain with x-rays and CT and MRI scans in people under 55 costs about $175 million.
  • Ordering electrocardiograms (ECGs) to look at heart activity in low-risk patients costs over $3 million.
  • Prescribing antibiotics to children for pharyngitis, or sore throats, without testing positive for streptococcus costs $116 million. Telling children to take over-the-counter cough and cold medicines costs over $10 million.

See the others in table form here.

The work was published this week by the Archives of Internal Medicine, as part of the Less is More series coinciding with the Sixth Annual Meeting of the National Physicians Alliance in Washington DC this weekend.

Image: TaxBrackets/Flickr

This post was originally published on Smartplanet.com

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