A recent article in the American Journal of Medical Quality reviewed 366 cardiac-related medical studies and 21 practice guidelines to identify eight measures of potential waste in hospital cardiac services.4 The wasteful measures included excess use of higher-cost implantable cardioverter-defibrillators and similar cardiac devices, the use of dual-chamber defibrillators rather than single-chamber devices, and excess lengths of stay in the hospital. The eight measures were validated with data from 261 hospitals.
The authors emphasize that their set of measures is not designed to determine clinical appropriateness but to highlight areas of potential overutilization that can be benchmarked with other hospitals.
Larry Beresford is a freelance writer in San Francisco.
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