MANAGING A BUSINESS RESOURCE

Managing a Business Resource

Managing a Business Resource

Part I: Recommendation

Interventions that are effective for older people care setting are likely to have a substantial impact on increasing the “quality and years of healthy life”. Improving quality of life is a primary objective of Healthy People 2010, a program of the Office of Disease Prevention and Health Promotion of the U.S. Department of Health and Human Services. Implicit to achieving this goal is to employ clinical preventive services.

I recommend that people who follow generally accepted preventive healthcare measures will have lower total healthcare expenditures because of an overall benefit derived from either preventing or treating health problems at an early, and presumably more treatable, stage.

I demonstrate that among non-institutionalized United States citizens, those who followed generally accepted preventive healthcare practices spent more for their total healthcare. This spending was focused on increased outpatient and prescription expenditures. We employed “current influenza vaccination” by respondents aged 65 years and older and surveillance of blood pressure within the past 2 years by adults as surrogates to identify people who are more likely to employ preventive healthcare measures.

We demonstrated that respondents employing these preventive healthcare measures were spending more money for their healthcare even when adjusted for potential confounding factors including health risk related to associated co-morbid conditions, education, age, perceived health status, perceived mental health, family size, poverty category, race, and sex. It is noteworthy that moderate and high-risk respondents, aged 65 years and older, who had current influenza vaccination did not have significantly higher expenditures for healthcare than those without current vaccination. Indeed, there was a nonsignificant trend for decreased spending by these groups for emergency room and in-patient expenditures.

Now for our organization I feel that the assumption that people who have influenza vaccination within the past year or their blood pressure checked within the past 2 years are more likely to follow other preventive healthcare recommendations is intuitively reasonable. Furthermore, this assumption was supported by our preliminary analysis showing that those with current influenza vaccination were significantly more likely to have followed a variety of other preventive healthcare recommendations. Total healthcare expenditures of people identified as following a whole variety of preventive healthcare measures all showed an increased spending by the individuals following vs. those not following the measure. Thus, we feel our data support an association between greater total healthcare expenditure and utilization of preventive healthcare measures.

Prior analyses have examined the cost-benefit and cost-effectiveness of various preventive healthcare practices. These analyses estimate the cost of a specific preventive intervention and then assign a monetary value to certain outcomes (cost-benefit) or alternatively determine the value of the intervention in terms of a health outcome, for example, the cost to save a year of life (cost-effectiveness). A prior study provided estimates of the lifetime costs for idealized (healthy lifestyle and no risk factors) patients who followed the preventive healthcare recommendations listed in the USPSTF Guide to Clinical Preventive Services. Another study examined the cost-benefit of a large-scale community-screening ...