Top 10 Healthcare Quality Issues for 2011

Cheryl Clark, 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.

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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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