Like many Western nations, the USA has a rapidly aging population. Low birth rates and better self and medical care mean that more Americans are reaching retirement age than ever. Over 49 million of us are now over the age of 65, representing a little more than 15% of the population, according to US government census figures.
A recent study appearing in the journal Surgical Endoscopy earlier this year, reveals that older patients are less likely to undergo minimally invasive surgical procedures.
With an aging population, this means that elder Americans are not only being under-served, but that unnecessary strain is being placed on our Medicare system, for several reasons. Let’s examine more the study’s findings.
Study leads examined the healthcare records of 200,000 patients covered by Medicare. Their conclusions are that older Americans could greatly benefit from better outcomes were MIS procedures to be more actively promoted to them.
As we’ve discussed on this blog before, all types of minimally invasive surgery (including spinal surgery) offer patients faster recovery times, less time in a hospital and a greatly reduced risk of complications. Elderly patients especially are put at risk when they’re not given access to MIS, for whatever reason.
With respect to the risk of complications, even one such event arising from surgery can create a complex of issues in older patients. These can create a domino effect, creating the perfect storm of exacerbating existing health conditions and elevating costs.
7 common conditions
The study focused on data concerning the most common conditions older patients are treated for, namely cholecystectomy (removal of the gallbladder), colectomy, hysterectomy, bariatric, inguinal hernia, ventral and thoracic hernia.
Using Medicare data, study leads examined outcomes for patients undergoing the 7 procedures noted. Also analyzed were the rates of readmission and the odds of complications for each procedure in the limited data set used, detailing results for the demographic under discussion.
The data used examined outcomes for open surgery against those for MIS. MIS accounted for fewer complications in the 5 of the 7 procedures. Readmission rates and time in a hospital were reduced for 6 of the 7 in both instances.
The conclusion drawn was the low prevalence of MIS in older patients pointed to lower-value care for this demographic and an inefficient use of resources in instances where MIS might have been called on.
Lower costs, better care
MIS procedures lowered the cost of care for 4 of the procedures examined by the study. It was also shown that MIS was extended to the rest of the patient population more frequently than it was for older patients.
Clearly, our healthcare system could benefit from some key changes. With respect to Medicare and the population it serves, more efficient allocation of resources would result were MIS to be applied with greater frequency. Shorter hospital stays and reduced risk of complications are major factors in this reality.
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