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Unnecessary Repeat Testing in Medicare Patients Shows Regional Practice Variation — Physician’s First Watch

Medical News |
November 20, 2012

Unnecessary Repeat Testing in Medicare Patients Shows Regional Practice Variation

Retesting of Medicare patients at intervals that are shorter than expected shows wide variation across the U.S., according to a study in the Archives of Internal Medicine.

Researchers followed some 750,000 Medicare beneficiaries for 3 years after an index test for cystoscopy, upper endoscopy, chest CT, pulmonary function, echocardiography, or stress testing with imaging. During that time, for example, half the pulmonary function tests were repeated, as were over a third of the upper endoscopies.

Regionally, echocardiography was performed on almost half the Medicare sample in Miami, Florida, versus 18% in Portland, Oregon. Those tests were repeated within 3 years two thirds of the time in Miami and about half the time in Portland.

Commentators grant that repeated testing is sometimes justifiable, but that repetition because of patient demand, malpractice worries, and profitability is not. They call for "faster retirement of fee-for-service incentives."

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