St. Dominic’s Health Services, the largest consumer mentioned in the report, regularly examines patient care and quality measurements against best-known clinical practices, said Scott Kashman, chairman of the health systems market operation for health services. Although health system leaders have not fully reviewed the Johns Hopkins findings, “we are committed to exploring this study and taking all necessary action to ensure that our patients, community and region receive the most exceptional, safe and effective treatment,” he said. he.
The USMD Health System, Community Medical Center and Care New England Health System did not respond to requests for comment.
At the other end of the spectrum, the health systems that perform these unnecessary services the least are more likely to be academic medical centers, hire more primary care physicians, provide a disproportionate amount of uncompensated care, or use integrated delivery models, the study shows.
“Primary care physicians have a role to play in coordinating care and ensuring that procedures are not repeated if they have already been performed and that specialists are not used if it is something that can be managed by the primary care physician,” said Dr. Jodi Segal, lead author and professor at Johns Hopkins University School of Medicine.
Major not-for-profit health care systems such as the Pittsburgh-based Allegheny Health System, the Houston Methodist in Texas and the Houston-based Memorial Hermann Health System provided below average amounts of unnecessary care. according to the study.
Dignity Health in San Francisco and Danville, Pennsylvania-based Geisinger and Seattle-based Group Health (owned by Kaiser Permanente of Oakland, California, since 2017) fell into the average category. All of these systems are not-for-profit.
The study found that the more medical groups a healthcare system owns, the more unnecessary care is provided, a finding that could help hospital managers explore how to expand services while maintaining quality.
“As hospitals restructure themselves into larger and larger systems, the senior management of hospitals will have to own this problem,” said Dr. Vikas Saini, president of the Lown Institute, a think tank in the healthcare sector that has studied overconsumption.
Johns Hopkins researchers plan to continue their research by examining health systems with average or below-average use of the procedures, especially those with characteristics similar to those of the largest consumers. The practices of these hospitals could offer insights to their peers with higher use of unnecessary services, the study says. Further research is also needed to determine what factors contribute to overconsumption, such as which medical specialists provide the services, what types of patients receive them, and what are the rationales behind these practices.
The Johns Hopkins researchers did not include pediatric hospitals, behavioral health centers, rehabilitation hospitals, or psychiatric hospitals in their analysis.