A SURVEY of German doctors found 40 per cent of them would not undergo the treatments they recommended to their patients, according to a German economist. He also said a conference on radiography was told that a third of X rays were superfluous.
Dr Eberhard Wille, head of the economics department in the University of Mannheim, gave the keynote address to the AIM (Association Internationale de la Mutualite) in Dublin yesterday. Dr Wille urged delegates to seek improvements in the delivery of effective treatments. "Innovations and pseudo innovations should be the subject of cost benefit analysis," he said.
Another speaker disclosed earlier that 50 per cent of German specialists would not undergo the operations they recommended to their patients. Dr Eckart Fiedler, of the German health insurance company BARMER Ersatzkasse, said this suggested many operations were unnecessary.
Aspects of consumption of health care, like lengths of hospital stay and use of drugs, varied widely without any apparent relationship to the health of the population, he said.
For example, average lengths of stay varied between six days in the US and 45 days in Japan, and French drug consumption was twice as high as Germany's.
It is necessary to involve doctors and other medical staff in containing medical costs, according to Prof Ad Dunning, special health adviser to the Dutch government.
A recent survey showed that in cardiology, for example, staff did not know or could not guess the costs of tests they routinely recommended. Treatments should be evaluated, and information on their effectiveness disseminated.
Doctors and hospitals should be rewarded for implementing cost effective guidelines. It might be worthwhile to spend money on assessing technology to prevent its unnecessary application.
Dr Etienne Caniard, general secretary of a French foundation for applied medical research, told the conference that the French system was going through a period of upheaval, which involved changing the emphasis from spending on entrenched institutions to spending on health needs.
Dr Doeke Post from the University of Groningen in the Netherlands said new technologies should not be put on the market until their improvement on the old ones was established.
The growth in health costs arose from several causes, he said. The ageing population meant an increase in chronic diseases, which would bring a growth in medical technology. There were more techniques and drugs which were not being critically tested for their additional value.