Association of Postdischarge Spending and Performance on New Episode-Based Spending Measure

When I was an intern, we frequently placed urinary catheters in hospitalized patients. For some diagnoses, like congestive heart failure, we believed placement of a urinary catheter was almost mandatory to accurately measure fluid output during diuresis. We were well meaning and thought more monitoring of intake and output meant better care. The problem was that we focused more on getting information than how it actually added value to our clinical assessment, and we did not consider the possible and likely complications of catheter placement. In most cases, the risks of catheter placement outweigh any possible benefits.