Leader's Edge: Splurging on Surgeries

It’s difficult to pinpoint the exact amount of wasteful health care spending that occurs each year in the United States, but estimates put it at 25% to 30% of the total health care spending. 

This unnecessary spending is due to myriad factors--one being unnecessary procedures, such as stents given to people with stable coronary artery disease.

In 2020, a large study, called the International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (Ischemia) trial, was done that confirmed this approach. Most of these patients had stable cardiovascular disease, and about 35% had no chest pain prior to enrollment. The patients were randomly assigned to receive either conservative therapy or testing and surgery.

The researchers found that outcomes for both groups were generally the same. Using stents did not reduce the number of cardiac events or deaths over a three-year period. The one thing that did change was quality-of-life measures. For people who originally had angina, they reported better quality of life after receiving a stent.

“The implications for lowering costs are profound,” says Dr. John Spertus, director of health outcomes research at Saint Luke’s Mid America Heart Institute and co-principal investigator for the Ischemia trial. “We used to use stress tests to diagnose and decide who needed to go to the cath lab. But it turns out it did not help differentiate who would benefit from surgery.”

Read the full Leader's Edge article: Splurging on Surgeries