3

There is a lot of variation in levels of medical treatment and spend across the USA. That variation has been studied by, for example, The Dartmouth Atlas Project. They conclude that more isn't better:

In regions where there are relatively fewer medical resources, patients get less care; however, there is no evidence that these patients are worse off than their counterparts in high-resourced, high-spending regions. Patients do not experience improved survival or better quality of life if they live in regions with more care. In fact, the care they receive appears to be worse.

Is is true that more medical interventions and higher spend don't improve the outcomes for patients?

matt_black
  • 56,186
  • 16
  • 175
  • 373
  • It would be better to have some time frame or location frame, since this claim is too broad. It could be counter-proved, for example, showing how life expectancy improved a lot since middle age, or how patients who have received medical care after suffering some heart condition have more life expectancy then those who had none. – woliveirajr Jan 26 '17 at 12:07
  • @woliveirajr There is an implicit timeframe (the latest few decades) and location frame (the claim is based on data for the USA, but I don't want to rule out other evidence elsewhere). – matt_black Jan 26 '17 at 12:34
  • Freakonomics recently had 3 bad medicine podcasts, i think one of the claims was similar. – user5341 Jan 26 '17 at 12:50
  • As an example - broader testing for things like PSA in older men has resulted in more surgeries to remove prostates. These surgeries are not without risk from immediate and/or long-term side effects - and PSA is not a direct test for cancer. –  Jan 26 '17 at 22:31
  • Are you asking if the association claim is accurate, or if it is causal (doing more medical procedures makes people sick). – De Novo Nov 07 '18 at 18:13
  • Higher than what? What kind of patient (age, pre-existing condition, general health)? What illnesses (appendicitis, common cold)? – RedSonja Nov 09 '18 at 14:08
  • @RedSonja For groups of comparable patients (say populations with similar age structure and disease profile) which get the best outcomes: very high levels of medical intervention, moderate levels of intervention or low levels of intervention? Not even that hard since there is a lot of variation both among different countries and in different parts of countries. – matt_black Nov 09 '18 at 14:12

2 Answers2

1

In a 2014 study, three doctors from the Department of Surgery, University of Michigan, Ann Arbor determined that programs with more medical interventions in the form of hospital treatment intensity (or "aggressive treatment style") have differing outcomes from the others. The found that these programs are better at rescuing patients, but did have higher complication rates.

We observed a small, but statistically significant, increase in the rates of major complications for patients treated at high– compared with low–care intensity centers. In contrast, failure-to-rescue rates were lower at high–care intensity hospitals, potentially indicating differences in complication management compared with low–care intensity centers. Despite this, HCI explained a small proportion of the overall variation in failure-to-rescue rates across hospitals.

https://jamanetwork.com/journals/jamasurgery/fullarticle/1909804

The also noted that this kind of program "is highly correlated with per-patient health care expenditures."

elliot svensson
  • 2,883
  • 13
  • 38
0

No, more medical interventions and higher spend don't automatically improve the outcomes for patients. At this point we have an enormous amount of medical literature claiming for the reduction of overdiagnosis and overtreatment. More and more interventions are approved with clinical trials that are far from mirroring the real-world, with strict inclusion criteria and surrogate endpoints. The BMJ’s Too Much Medicine initiative was launched for facing the threat to human health posed by overdiagnosis and unnecessary care.

https://www.bmj.com/too-much-medicine

paoloeusebi
  • 109
  • 2