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Low Value Care Costs Patients and Payers $134 Million Per Year

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Symptoms of asthma are similar to the more common condition of bronchiolitis, and taking medicines designed for asthma alone can be risky. (Adobe Stock)
Symptoms of asthma are similar to the more common condition of bronchiolitis, and taking medicines designed for asthma alone can be risky. (Adobe Stock)

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 Eric Galatas, Producer

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Wednesday, August 23, 2023   

Coloradans received nearly 2 million potentially unnecessary health care services in 2021, at a cost of some $134 million for patients and health insurers, according to a new report

Dr. Lalit Bajaj, chief quality, equity and outcomes officer with Children’s Hospital Colorado explained, avoiding “low-value care” procedures – which can include certain tests and overprescribing drugs – is not about saving money. Many treatments can lead to complications and negative health outcomes.

“And oftentimes the best care is not doing tests that are potentially harmful, because they lead you down the wrong diagnosis, or they are directly harmful like radiation or inappropriate antibiotic use,” Bajaj said. 

Analysis by the Center for Improving Value in Health Care found that of the 58 services evaluated statewide, inappropriately prescribed opioids was by far the costliest, coming in at nearly $48 million dollars, 36% of all low value spending.

Poor air quality along Colorado’s Front Range has many parents worried that their child may be developing asthma, which Bajaj noted can present symptoms similar to the more common condition of bronchiolitis in children under age two. Giving kids who do not have asthma medicines specifically designed to treat the condition can backfire, Bajaj explained.

“And kids can have a pretty dramatic adverse reaction to that, and drop their oxygen in their blood, and that can cause more problems,” he continued. “So, it’s more harm than good.”

Bajaj said after years of robust clinical research involving tens of thousands of patients, the team at Children’s Hospital Colorado has developed a roadmap for delivering what he calls high-value care. For example, kids who suffer a head injury – but do not show high risk signs such as loss of consciousness – don’t need to risk high amounts of radiation in a CAT scan.

“Who should I image with a head injury? And I know that answer,” Bajaj said. “Who should I observe? We know that answer. Who can safely avoid imaging and go home? And we are much better with those answers due to our research.”