Revascularization of AMI Patients Persists Despite No Demonstrated Benefit
Hospital teams commonly perform revascularization procedures more than 24 hours after patients have experienced acute myocardial infarction even though studies have found no benefit because too much muscle damage has already occurred.
"I think there has been a very long standing belief – a strong belief – that having an open artery long term is better than having a closed artery. And that belief is coupled by the fact that you can get paid to do the procedure, coupled with the fact that patients...don't want to have a closed artery. They know you can open it up," corresponding author Judith Hochman, MD, said in an interview.
"I don't think it's only for the money" that the practice persists, she said.
She added that another factor is that since the findings in those studies did not show that the patients were significantly harmed from the procedure, there has probably been a delay in implementing practice changes. "To have a negative study may take longer to impact a practice than a positive study," she said.
"And there's another aspect, which is that the whole malpractice issue is a big consideration. You leave an artery closed and the patient has a bad outcome, you're much more likely to be liable than if you say 'I did everything I could.' "
"The reasons are multi-factorial. It takes a long time, sometimes, for a recommendation to filter down to practice."
- As Medicare Advantage Cuts Loom, Disagreement Over Program's Stability
- Doctors Feel Pressure to Accept Risk-based Reimbursement
- Surgical Checklists Unused in 10% of Hospitals, CMS Data Shows
- Centralizing the Revenue Cycle Protects the Bottom Line
- A Fresh Look at End-of-Life Care
- 3 in 4 Patients Want E-mail Consultations
- Heart Attack Patient Costs Skyrocket Beyond 30 Days
- CA Fines 8 Hospitals for Medical Errors
- ACGME Chief Sees 'Huge' Risk of Error in Proposed Assistant Physician Licensure
- 3 Insider Tips on Cutting Costs without Strangling Growth