Treatments - Diagnostic And Therapeutic Procedures

The database that provides an insight into operations also lets us see a little into the details behind some 12 million diagnostic and therapeutic procedures carried out in 2000. Roughly the same number were performed ten years earlier in 1990.

In a sense we see here the rather dynamic transformations that have taken place in the treatment of diseases in just a ten year period. Looking into the arteries and into the inner workings of the heart, using contrast materials — angiography and angiocardiography — are the top ranking diagnostic procedures in both benchmark years. We saw in the previous panel that heart-related operations have increased. Here we see a reflection of that in diagnostic procedures — which are more numerous in 2000 than ten years before.

Total procedure are up slightly, but the leading procedures — heart-related procedures alone excepted — are down. Fewer respiratory therapy procedures were performed. Ultrasound seems to have lost ground. CAT scans seem to have lost their popularity. The administration of chemotherapy substances has come to the fore — a therapeutic procedure.

To be sure, the procedure shown — and selected by the compilers of the National Hospital Discharge Survey — are a limited part of all procedures counted. In 1990, the NHDS showed 64% of such procedures in detail, in 2000 only 43%. One inference of that (no explanations are offered in the source) is that in 2000 many more procedures were in use, suggesting that both diagnostic and therapeutic methods have proliferated, have become more specific, and are applied with more discrimination these days. Tools are being refined.

This, in fact, appears to be a trend in medicine these days — and may well continue in the future. It is reflected in better understanding of diseases (see the panel entitled Emerging Diseases: Many Pathways in Chapter 2) and the corresponding fine-tuning of pharmaceutical treatments and medical interventions. Thus well-known tools are applied more sparingly and others are, one imagines, too numerous to mention.

A brief note about procedures that may not be familiar. Endotracheal intubation is a procedure whereby a tube is inserted through the nose into the throat to help a patient breathe. Radioisotope scans require the introduction of radioactive materials into the body — say by injection, by a drip. Cameras placed close to the organ being studied can obtain images. Diagnostic ultrasound makes use of high-frequency sound waves, beyond human hearing, to create images of organs and bones. Several different imaging systems may be used in conjunction.

We turn next to take a look at the age-distribution of those who undergo operations now — and then.

Source: 2000 National Hospital Discharge Survey, Advanced Data from Vital and Health Statistics, Number 329, June 19, 2002. 1990 data from National Hospital Discharge Survey: Annual Summary, 1990, Series 13, Number 113. Vital and Health Statistics, U.S. Department of Health and Human Services. MEDLINEplus quote taken from http://www.nlm.nih.gov/medlineplus/ency/article/002351.htm.