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Top 10 Healthcare Quality Issues for 2011

Cheryl Clark, for HealthLeaders Media, January 3, 2011

Here are the top quality challenges healthcare providers will face in 2011—many, such as imaging  exposure effects, central line infections, and medical data breaches dominated headlines in 2010. 

1. Imaging Scan Radiation Exposure and Overutilization

This issue caught the number one spot for several reasons.

Concerns about overutilization of imaging involving radiation, especially the use of CT, have been snowballing over the last two years. Scientists writing in the Journal of the American Medical Association said the situation may have gone too far.

In July, David J. Brenner of the Center for Radiological Research, Columbia University Medical Center and Hricak, MD of the Department of Radiology, at Memorial Sloan-Kettering Cancer Center, suggested that the time for national regulation of the industry has come.


Top 12 Healthcare Quality Concerns in 2012
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"Radiation exposure from medical radiographic imaging is comparatively unregulated; this is in striking contrast to radiation exposure in occupational settings, which is stringently regulated despite it contributing a far smaller population exposure," he and his colleagues said in their research.

They noted that the average radiation dose to which persons in the U.S. are exposed to has doubled in 30 years, and that while background doses have not changed, "the average radiation dose from medical imaging has increased more than 6-fold."

The cost of imaging has also come under critique in an article published in an April issue of the Journal of the American Medical Association.Imaging tests in cancer care for Medicare patients accounted for 57% of all cancer costs in 2004, suggesting that the study population "represented the majority of cancer costs borne by Medicare beneficiaries."

In 2011, this quality issue remains a pressing concern.

Attention is often focused on the number of patients who are referred for imaging tests by physicians who own the machinery. A series of articles in a recent issue of the journal Health Affairs say they don't result in shorter length of illness, as many physicians who defend the practice claim.

And rather than reducing costs, the price per episode of care generally averages 4% to 10% higher when the physician self-refers a patient.

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3 comments on "Top 10 Healthcare Quality Issues for 2011"


Anne Jarrett MS, RPh (2/7/2012 at 4:55 PM)
I would like to add a comment on the subject of dialysis and the expense related to it. I am a pharmacist who established a pharmacy at a transplant center to help patients obtain their medications, and I have a unique perspective. The meds transplant patients take are very expensive, even after Medicare pays 80%. After transplant,Medicare covers these patients for 3 years only. I saw patients who could not afford their meds, did not take them, and often had to be readmitted numerous times to receive I.V. drugs. Drug manufacturers have ever changing pt. assist. programs,rendering a sig. amt. of pts. ineligible. Result:Patients were re-transplanted only to start the cycle again. All of which was paid for by Medicare,including being,back on dialysis while waiting for another kidney. What's wrong with this picture?

Helen Erickson (1/7/2011 at 9:34 PM)
This approach has been around for many years, has been demonstrated to be effective, but requires a mind set about the worth of the person's self-care knowledge. The attached video provides information about the use of this approach at The Univer of TX Health Science Center, San Antonio http://www.youtube.com/watch?v=DhYeeVghhQU

Bogey (1/4/2011 at 9:00 AM)
Interesting that none of the concerns from the provider perspective is about lowering the cost of care, the single largest driver of high insurance prices and medicine today. And one wonders when providers will "get it," that it is the rising cost of care and the lack of MARKET forces (not government regulation) to drive down cost that propels us toward the iceberg, as providers rearrange the chairs on the deck of the Titanic.