According the a 2008 Leapfrog Hospital Survey, below are the proportion of each type of medical procedure that met quality standards:
- Coronary artery bypass graft: 43%
- Percutaneous coronary interventions: 35%
- High-risk deliveries: 32%
- Pancreatic resection: 23%
- Bariatric surgery: 16%
- Esophagectomy: 15%
- Aortic valve replacement: 7%
- Aortic abdominal aneurysm repair: 5%
Source: Binder and Rudolph (HSR 2009)
why doesn’t medicare simply cut off those hospitals with unacceptable practices like you describe?
Medicare is moving towards reducing payments for those with unacceptable practices. Totally cutting off hospitals may (or may not) be counter productive. Shutting down a hospital may leave a community without a source of medical care.
Further, Using observational research studies, you can estimate how many procedures are unnecessary. However, it is way to expensive to have Medicare supervise every doctor at every hospital. Instead, Medicare has to go off of claims data. If one hospital has many more surgeries than another, this may be because they are doing a unnecessary procedures or because they have a sicker patient base.
It is similar to when you take your car in for a repair. Do you really need to have a part replaced or not? It is difficult to tell. An investigative journalist could take a mint condition car to the repair shop and see if they would repair it, but doing this for every repair shop in town is expensive.