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Related Experiment Videos

What is unnecessary surgery?

M V Pauly

    The Milbank Memorial Fund Quarterly. Health and Society
    |January 1, 1979
    PubMed
    Summary

    Defining "unnecessary surgery" is challenging. A patient-centered economic approach suggests most surgeries are not unnecessary when considering informed patient preferences and costs.

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    Area of Science:

    • Health Economics
    • Medical Ethics
    • Surgical Outcomes

    Background:

    • The definition of "unnecessary surgery" lacks precision.
    • Existing definitions do not adequately incorporate patient perspectives.
    • Congressional reports have raised concerns about unnecessary surgical procedures.

    Purpose of the Study:

    • To propose a precise definition for "unnecessary surgery" using economic principles.
    • To evaluate the evidence base for claims of widespread unnecessary surgery.
    • To assess the implications of current definitions for patients and physicians.

    Main Methods:

    • Utilized the economic concept of patient costs and benefits from a fully informed patient-consumer perspective.
    • Integrated clinical data with patient preferences to define surgical necessity.
    • Reviewed evidence supporting conclusions in recent Congressional reports.

    Main Results:

    • A precise definition of "unnecessary surgery" can be formulated using an informed patient-consumer economic model.
    • It is challenging to demonstrate unnecessary surgery for most diagnoses when considering combined clinical and patient preference data.
    • Evidence in recent Congressional reports does not robustly support claims of widespread unnecessary surgery.

    Conclusions:

    • The economic model provides a useful framework for defining unnecessary surgery.
    • Current evidence does not substantiate broad claims of unnecessary surgical procedures.
    • Recommendations for physicians and patients should be evidence-based and consider patient-specific factors.

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