Home E-Weekly March 13, 2018

Older Patients Missing Out on Benefits of Minimally Invasive Surgeries

Published: March 13, 2018

Elderly Woman MISSING BENEFITS MIS procedures usually result in lower complications and hospital stays but elderly patients are more likely to have an open surgery procedure.

Previous studies have shown that elderly patients don't undergo as many minimally invasive surgery (MIS) procedures as the general population. A new study measures the impact of more open surgeries, chief among them longer hospital stays and higher chances of readmission.

The study in Surgical Endoscopy reviewed data from 200,000 Medicare patients who underwent 7 common surgical procedures: gallbladder removal, bariatric, colectomy, hysterectomy, inguinal hernia, and thoracic and ventral hernia. For all procedures, Medicare patients were scheduled for MIS procedures at a lower rate than the general population.

For 5 of the reviewed procedures, patients that underwent MIS procedures had lower complication rates. Patients also had lower readmission rates and spent less time in the hospital for 6 of the 7 procedures.

The report also analyzed Medicare costs. For 4 of the 7 procedures, MIS costs were lower, suggesting that not only are elderly patients missing out on better outcomes but payers are missing out on cost savings.

"This study shows there is an opportunity for Medicare and other payers to spend healthcare dollars more wisely so that they reward high-value care over low-value care" says Martin Makary, MD, MPH, professor of surgery at the Johns Hopkins University School of Medicine and lead author of the study. Dr. Makary says the study shows that "underuse of MIS for eligible candidates in the Medicare population is an example of low-value care."

JoEllen McBride, PhD

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