Low-value procedures linked to more hospital-acquired complications

The use of low-value procedures, or those that would not be expected to require hospitalization, was linked to more hospital-acquired complications in a study published in JAMA Internal Medicine.

The researchers analyzed hospital admission data from 225 hospitals in Australia to find patient harm linked to low-value procedures not expected to require admission. They evaluated 9,330 episodes involving one of seven low-value procedures, including colonoscopy for constipation in patients under age 50 and knee arthroscopy for osteoarthritis.

They measured harm linked to low-value care based on 16 hospital-acquired complications, including respiratory complications, renal failure, gastrointestinal bleeding and delirium. They also calculated the percentage of hospital-acquired complications for each low-value procedure and the difference in mean length of stay receiving a low-value procedure with and without any complications.

They found the use of these seven procedures in patients who probably should not have received them harmed some of those patients, consumed extra hospital resources and potentially delayed care for other patients.

"Although only some immediate consequences of just seven low-value services were examined, harm related to all low-value procedures was noted, including high rates of harm for certain higher-risk procedures," the researchers concluded. "The full burden of low-value care for patients and the health system is yet to be quantified."

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