Johns Hopkins study names health care systems that provide the most ‘unnecessary’ care

St. Dominic’s Health Services, named a leader in healthcare overuse in the report, routinely rigorously reviews patient care and quality measures against best-known clinical practices, said Scott Cashman, President, Health Systems Marketplace Operations. While health care leaders have not yet fully considered the Johns Hopkins findings, “we are committed to reviewing this study and taking all necessary steps to ensure our patients, community and region receive the most exceptional, safe and effective care,” he said.

The USMD Health System, Community Health Center and Care New England Health System did not respond to requests for comment.

At the other end of the spectrum, health systems that provide the least of these unnecessary services are more likely to be academic health centers, employ more primary care physicians, provide a disproportionate amount of unpaid care or use integrated care models, as research shows.

“Primary care physicians have a role to play in coordinating care and in ensuring that procedures are not repeated if they have already been performed and that specialists are not used if that is something that the primary care physician can manage.” said dr. Jody Segal, lead author and professor at the Johns Hopkins University School of Medicine.

Large nonprofit health systems such as Allegheny Health System in Pittsburgh, Houston Methodist in Texas, and Memorial Hermann Health System in Houston provided below-average unnecessary care. according to research.

Dignity Health of San Francisco, as well as Geisinger of Danville, Pennsylvania, and Group Health of Seattle (since 2017 owned by Kaiser Permanente of Oakland, California) fell into the middle category. All of these systems are non-commercial.

The study found that the more groups of physicians that belong to the health system, the more unnecessary care is rendered, and this finding could help hospital managers explore ways to scale up services while maintaining quality.

“As hospitals restructure into larger systems, senior hospital management will have to acknowledge this problem,” said Dr. Vikas Saini, president of the Lown Institute, a health think tank that studies overuse.

The Johns Hopkins University researchers plan to continue their research by studying healthcare systems with average or below average usage of procedures, especially those with characteristics closer to the biggest overusers. The study says these hospitals’ practices may inform their peers with higher use of unnecessary services. Further research is also needed to determine what factors contribute to overuse, such as which medical professionals provide services, which patients receive them, and what are the reasons for this practice.

The Johns Hopkins researchers did not include children’s hospitals, behavioral health centers, rehabilitation hospitals, or psychiatric hospitals in their analysis.

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