Too Much Medical Care Harmful?

Too much medical care could be harmful to your health.

That's what researchers concluded after examining the nations' hospitals and the care patients receive. Some hospitals and some areas of the country give patients more aggressive care -- meaning more tests, longer hospital stays and more procedures -- than others. And the extra treatment doesn't always translate to longer or better lives.

The 2008 Dartmouth Atlas of Health Care study, released Thursday, studied more than 4 million Medicare patients at nearly 3,000 hospitals across the country from 2001 through 2005 during the last two years of life.

The patients were 65 years and older and were treated for the top nine leading causes of death, including congestive heart failure, chronic pulmonary disease, cancer, dementia, coronary artery disease, chronic kidney failure, peripheral vascular disease, diabetes with organ damage and severe chronic liver disease.

The study found that depending on where patients lived and what hospital they went to, there were big discrepancies in how they were treated.

Researchers reasoned all medical care carries some risk, so the longer a patient is hospitalized and the more procedures and tests performed, the greater the risks, in addition to greater costs.
The more resources available at a hospital equaled more care and in turn, more chances for errors and complications, according to the study.

To help consumers better identify which hospitals are more or less aggressive with their care, Consumer Reports magazine launched the Consumer Reports Health Ratings Center, which ranks hospitals and soon will rate other health care providers.

Launched in conjunction with the Dartmouth study, the online tool at ConsumerReportsHealth.org lets consumers compare treatment approaches among hospitals for the nine serious chronic conditions in the study on a scale from 0 percent to 100 percent (the higher the percentage the more aggressive the treatment).

The percentile rank is based on the total number of hospital days and inpatient physician visits over the last two years of life. Next to each of the nearly 3,000 hospitals, there also are the patient out-of-pocket costs over the last two years of life.

For example, hospitals in New York and Los Angeles top the list of most aggressive care, while Scott & White Memorial Hospital in Temple, Texas, is the most conservative.

Seattle ranks on the lower, more conservative end of the spectrum when treating patients.
Of the 18 Seattle-area hospitals listed on the site, larger ones such as Swedish Medical Center, the University of Washington Medical Center and Virginia Mason had higher percentiles. They ranked 44 percent, 33 percent and 29 percent respectively.

Jefferson Healthcare in Port Townsend, St. Francis Hospital in Federal Way and Olympic Medical Center in Port Angeles ranked on the low end at 2 percent and 3 percent.

The numbers tend to be lower because the larger hospitals usually have more complicated cases, often referred to them by the smaller ones, according to the Washington Hospital Association.
The association said it was pleased with where Seattle and Washington as a whole fall on the Consumer Reports rankings, which indicates Seattle patients are getting the care they need and want, but are not getting a lot of unnecessary care.

"If we had any hospitals with exceptionally high scores, I would worry that patients were getting much more care than they needed or wanted," spokeswoman Cassie Sauer said.

"Spending hours and hours in medical appointments, tests and treatments -- particularly when there's no evidence they will make any difference -- could offer false hope, hurt quality of life, and create significant medical bills. I think many Americans assume that more care is better care, but that is certainly not always the case"