100,000 unnecessary surgeries were performed by hospitals during the first year of the pandemic

More than 100,000 ‘unnecessary’ operations were carried out by America’s hospitals during the first year of the COVID-19 pandemic, a report finds.

In its first report on the issue the Lown Institute, a healthcare think-tank in Boston, Massachusetts, said health centers barely shelved any of these unneeded operations despite the outbreak.

A surgery was marked as not needed if there was evidence it offered no greater benefit than an alternative, like prescription drugs. Heart stents, hysterectomies and procedures for back pain were included on the list.

Almost half of the unnecessary surgeries were stents for stable coronary heart disease, with the most being carried out by the Mayo Clinic in Minnesota, Cleveland Clinic in Ohio and Ronald Reagan UCLA Medical Center in California.

In the first three months after Covid hit the U.S., hospitals struggled to get patients through their doors, with many staying away for fear of catching the virus.

But by the winter wards were overflowing with patients during a major surge that proved to be the deadliest of the pandemic.

Dr Vikas Saini, the institute’s president, said: ‘You couldn’t go into your local coffee shop, but hospitals brought people in for all kinds of unnecessary procedures.

‘The fact that a pandemic barely slowed things down shows just how deeply entrenched overuse is in American healthcare.’

The Lown Institute in Boston, Massachusetts, said that health centers barely slowed down completing ‘unnecessary’ surgeries despite the outbreak. A surgery was marked as not needed if there was evidence it offered no greater benefit to an alternative, like drugs (stock)

The Lown Institute looked through claims data from Medicare — federal health insurance for people aged 65 years and over — for 2020.

It searched for eight procedures that the Institute considered to be unnecessary.

These included stents alongside vertebroplasty for osteoporosis — where a cement mixture is injected into a vertebrae, and hysterectomies — where the uterus is removed — for benign cancer patients.

What were the most common ‘unnecessary’ surgeries? 

  1. Stents for heart disease – 45,176
  2. Vertebroplasty for back pain – 16,553
  3. Hysterectomy for benign disease – 14,455
  4. Spinal fusion for back pain – 13,541
  5. Blood clot filter (IVC filter)– 9,595
  6. Artery disease surgery (Carotid endarterectomy) – 3,667
  7. Stent for kidney arteries (Renal stent) – 1,891
  8. Check for knee problems (Knee arthroscopy)– 1,596

Source: Lown Institute

In stent surgery a wire mesh is placed into a closed coronary artery to re-open it, raising the flow of oxygenating blood to the heart and cutting the risk of a heart attack.

But an ever-growing pile of studies dating back more than a decade shows that this procedure offers no greater benefit than taking medication to relieve high blood pressure and cholesterol. This includes from a JAMA Internal Medicine meta-analysis from 2012. 

Vertebroplasty is offered to people with a fractured vertebrae to relieve pain, although normally only after other treatments such as bed rests and a back brace have failed.

Studies initially suggested the procedure offered no benefit for pain relief.

But in 2016 another trial — called VAPOUR — was carried out in Australia, which found it could help with pain if done within six weeks of its onset and the pain was severe enough to lead to hospitalization.

Hysterectomies can be unnecessary in cases where the growth is benign, or not spreading, because it means only the tumor will need to be removed.

The procedures were carried out at a time when the nation was shifting in and out of lockdown, and many beds were being turned over to treat Covid patients.

At the peak of the crisis that data is available for there were 15,000 people being admitted with COVID every day in December 2020.

Researchers added that stent procedures were being overused across the U.S., including among its 20 top-ranked hospitals.

Dr Saini added: ‘We’ve known for over a decade that we shouldn’t be putting so many stents into patients with stable coronary heart disease, but we do it anyway.

‘As a cardiologist, it’s frustrating to see this behavior continue at such high levels, especially during the pandemic.’

The American Hospitals Association said that delays and cancellations in care may have negative impacts on patients.

It added, reports Fierce Healthcare: ‘Lown may define these services as “low value”, but they can be of tremendous value to the patients who receive them.’

Overall health care usage in America spiraled during the pandemic, with many Americans fearing heading to hospitals and clinics for non-Covid reasons.

A study published last year by Avalere found that usage among Medicare Fee-for-Service patients dropped 42 percent across the first three months of the pandemic — March, April and May of 2020 — when compared to the same months in 2019.

This led to hospitals facing revenue drops, as profitable procedures like hip and knee replacements were set aside — both to abide by social distancing guidelines and to clear out space in facilities to deal with surges of Covid patients.

Despite the growing needs for physicians during this period, hospitals were forced to layoff staff to balance their books, with more than 250 hospitals reporting layoffs in the first six months of the pandemic. 

Read more at DailyMail.co.uk