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Unwarranted surgery 'costing millions'

02 June, 2014

A new government report into the dramatic variations in rates for some surgical procedures should spur a vigorous response to curb unwarranted surgery costing the taxpayer many millions every year, the Consumers Health Forum (CHF) said in a statement last week (28 May).

"This report* is timely given that patients are being asked to pay more out of their own pocket for health care. It is clear Australia needs to take realistic steps to make the health system more efficient before further slugging consumers," the Chief Executive Officer of CHF, Adam Stankevicius, says.

"For instance, rates can vary three-fold for common knee operations and for hysterectomies, depending on locality in Australia. While there can be understandable factors like distance and service availability at play, these huge differences are not explained by those factors alone.

"We know that there are indications too many unwarranted knee arthroscopies are performed in Australia when these procedures are not as effective as physiotherapy, and expose patients unnecessarily to the risk of complications.

"The stated aim of this report is not to cut costs but to increase value. Health resources are increasingly scarce and we have to get much better at putting resources where they are most needed.

"CHF's Health Voices journal recently published a series of expert articles suggesting several ways we could reduce waste and improve efficiency in the health system before turning to patient co-payments.

"The new report shows that Australian consumers don't have reliable information about the outcomes of treatments like knee replacement.

"The chair of the Australian Commission on Safety and Quality in Health Care, Professor Villis Marshall, says the report's findings bring home the importance of patients being fully \informed about all their options when making health care decisions.

"CHF has argued before that Australia already has vast stores of data about the operation of the health system yet very little is put together to reveal more about the actual outcomes and cost effectiveness of different procedures.

"An example of how the release of performance data can help drive improvements is the latest report on hospital emergency department waiting times which have shown a big improvement between 2012 and 2013.

"The National Health Performance Authority report released … (Thursday May 29) showed that many major metropolitan hospital ED waiting times improved by ten or more percentage points.

Stankevicius concluded: "Improvements in regional hospitals were not as marked and it is to be hoped that this report will spur better outcomes for regional and rural health consumers seeking treatment in emergency departments."

*Exploring Healthcare Variation in Australia: Analyses Resulting from an OECD Study, produced by the Australian Commission on Safety and Quality in Health Care, and the Australian Institute of Health and Welfare.

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Dave S | Tuesday, June 3, 2014, 9:07 AM
The saddest thing about the lack of information is that it is exacerbated by surgeons who take no further responsibility for outcomes after the surgery, that is handballed to the GP, who wasn't at the operation to see exactly what happened. Thus pain complications that are persisting still 16 months after the surgery are passed of by the GP with standard responses like . . .'that does happen sometimes". The patient has no further redress, it seems there is no interest in finding out why there is still persistent pain. A lack of scientific enquiry it appears.
archibald | Monday, July 7, 2014, 3:06 PM
When I told my surgeon that he was just not holistic enough, he snorted and said "can't expect me to be- I'm a specialist surgeon". I now say, the SYSTEM also NEEDS to be holistic; Doctors, Physiotherapists and Nurses need patient focused effective ongoing communication to gain the desired end of rehabilitation after surgery.