Preventive health care (alternately preventive medicine, health care/preventive medicine, or prophylaxis ) consists of measures taken for disease prevention, compared with disease treatment. Just as health consists of various physical and mental states, as well as diseases and disabilities, which are influenced by environmental factors, genetic predisposition, disease agents, and lifestyle choices. Health, disease, and disability are dynamic processes that begin before the individual realizes that they are affected. Disease prevention depends on anticipatory measures that can be categorized as primary, secondary, and tertiary prevention.
Every year, millions of people die from preventable deaths. A 2004 study showed that about half of all deaths in the United States in 2000 were caused by preventable behavior and exposure. The main causes include cardiovascular disease, chronic respiratory illness, unintentional injury, diabetes, and certain infectious diseases. This same study estimates that 400,000 people die every year in the United States because of poor diet and an inactive lifestyle. According to estimates made by the World Health Organization (WHO), about 55 million people die worldwide in 2011, two thirds of this group from non-communicable diseases, including cancer, diabetes, and chronic cardiovascular and lung diseases. This is an increase from 2000, where 60% of deaths are caused by these diseases. Preventive health care is very important given the increasing prevalence of chronic diseases worldwide and deaths from this disease.
There are many methods for disease prevention. It is recommended that adults and children aim to visit their physician for regular checkups, even if they feel healthy, to screen for the disease, identify disease risk factors, discuss tips for a healthy and balanced lifestyle, stay up to date with immunization and strengthening, and maintaining good relationships with healthcare providers. Some common illness examinations include checking for hypertension (hypertension), hyperglycemia (high blood sugar, diabetes mellitus risk factors), hypercholesterolaemia (high blood cholesterol), screening for colon cancer, depression, HIV and other common types of sexually transmitted diseases such as chlamydia, syphilis, and gonorrhea, mammography (to screen for breast cancer), colorectal cancer screening, Pap tests (for checking cervical cancer), and screening for osteoporosis. Genetic testing can also be done to filter out mutations that cause genetic abnormalities or predisposes to certain diseases such as breast or ovarian cancer. However, these measures are not affordable for each individual and the cost-effectiveness of preventive health care remains a topic of debate.
Video Preventive healthcare
Prevention level
Preventive health care strategies are described at the primary, secondary, and tertiary prevention levels. In the 1940s, Hugh R. Leavell and E. Gurney Clark invented the primary prevention term. They work at the Harvard School of Public Health and Columbia University, respectively, and then expand the level to include secondary and tertiary prevention. Goldston (1987) notes that this rate may be better described as "prevention, treatment, and rehabilitation", although the primary, secondary, and tertiary prevention terms are still in use today. The concept of primary prevention has been created much more recently, in relation to new developments in molecular biology over the past fifty years, more specifically in epigenetics, which shows the importance of environmental conditions - both physical and affective - to organisms. during the life of the fetus and the newborn (or so-called primal life).
Prime and Primordial prevention
A separate category of "health promotion" has recently been proposed. This health promotion is based on â € Å"new knowledgeâ € in molecular biology, especially on epigenetic knowledge, which shows how much affective - as well as physical - the environment as long as the fetus and the newborn's life can determine every aspect of health adults. New ways to improve health are now commonly called primary prevention. It primarily consists in providing future parents with relevant, impartial information about primal health and supporting them during their primal lifetime (ie, "from conception to birthday first "according to the definition by Primal Health Research Center, London). This includes adequate parental leave - ideally for both parents - with family care and financial assistance if needed.
Another related concept is primordial prevention that refers to all measures designed to prevent the development of risk factors in the first place, early in life.
Primary prevention
Primary prevention consists of traditional "health promotion" and "special protection." Current health promotion activities, non-clinical life choices. For example, eat nutritious food and exercise daily, both of which prevent disease and create a sense of well-being as a whole. Preventing disease and creating overall wellbeing, extending our life expectancy. Health promotion activities do not target specific diseases or conditions but promote health and wellbeing at a very general level. On the other hand, special protection targets the type or group of diseases and complements health promotion objectives.
Food is the most basic tool in preventive health care. The 2011 National Health Interview Survey conducted by the Centers for Disease Control was the first national survey to include questions about the ability to pay for food. Difficulty paying for food, medicine, or both are the problems facing 1 in 3 Americans. If better food choices are available through food banks, public kitchens, and other resources for low-income communities, the obesity and chronic conditions that come with it will be more controlled. A "food desert" is an area with limited access to healthy food. because of the lack of supermarkets within a reasonable distance. This is often a low-income neighborhood with the majority of the population having no transport. There have been several grassroots movements in the past 20 years to encourage urban gardening, such as the GreenThumb organization in New York City. Gardening in urban areas uses vacant land to grow food for the environment and cultivated by local people. The new moving markets are another resource for the residents of the "food wasteland", which is specially equipped with buses bringing affordable fresh fruits and vegetables to low-income neighborhoods. These programs often organize educational events such as cooking and nutrition guides. Programs like this help provide healthy and affordable food for the people who need it most.
Scientific advances in genetics have significantly contributed to knowledge of hereditary diseases and have facilitated great advances in certain protective measures in individuals who are carriers of disease genes or have an increased tendency for certain diseases. Genetic testing has enabled physicians to make diagnostics faster and more accurate and has made it possible for customized treatments or personalized medications. Similarly, special protective measures such as water purification, sewage treatment, and the development of personal hygienic routines (such as hand washing regularly) are becoming mainstream in the discovery of infectious agents such as bacteria. This discovery has been instrumental in lowering the rate of infectious diseases that often spread in unhealthy conditions. Preventing Sexually Transmitted Infections is another form of primary prevention.
Secondary Prevention
Secondary prevention is associated with latent disease and attempts to prevent asymptomatic disease from progressing into symptomatic disease. Certain diseases can be classified as primary or secondary. It depends on the definition of what constitutes the disease, though, in general, primary prevention overcomes the root cause of illness or injury while secondary prevention aims to detect and treat disease early on. Secondary prevention consists of "early diagnosis and rapid treatment" to control disease and prevent its spread to other individuals, and "disability limitations" to prevent potential future complications and disabilities of the disease. For example, early diagnosis and prompt treatment for syphilis patients will include antibiotics to destroy pathogens and screening and treatment of infants born to syphilis mothers. Limitations of limitations for syphilis patients include further examination of the heart, cerebrospinal fluid, and central nervous system of patients to curb damaging effects such as blindness or paralysis.
Tertiary Prevention
Finally, tertiary prevention efforts to reduce the damage caused by symptomatic disease by focusing on mental, physical, and social rehabilitation. Unlike secondary prevention, which aims to prevent disability, the goal of tertiary prevention is to maximize the abilities and functions left over from disabled patients. Tertiary preventive goals include: preventing pain and damage, stopping the development and complications of the disease, and restoring the health and function of the affected individual. For syphilis patients, rehabilitation includes measures to prevent complete disability of the disease, such as applying workplace adjustments for the blind and paralyzed or providing counseling to restore normal daily functions to the maximum extent possible.
Maps Preventive healthcare
Leads preventable causes of death
United States
The main cause of death in the United States is tobacco. However, poor diet and lack of exercise may soon escape tobacco as the leading cause of death. This behavior can be modified and prevention and public health efforts can make a difference to reduce this death.
Worldwide
The leading cause of preventable death worldwide has the same tendency as the United States. There are some differences between the two, such as malnutrition, pollution, and unsafe sanitation, reflecting the health gap between developing and developed countries.
Child mortality
In 2010, 7.6 million children died before reaching the age of 5 years. While this is a decline from 9.6 million in 2000, it is still far from the fourth Millennium Development Goal to reduce child mortality by two-thirds by 2015. Of these deaths, approximately 64% are caused by infections (including diarrhea, pneumonia, and malaria). About 40% of these deaths occur in neonates (children 1-28 days) due to complications of preterm birth. The highest number of child deaths occurred in Africa and Southeast Asia. In Africa, there has been virtually no progress in reducing neonatal mortality since 1990. India, Nigeria, the Democratic Republic of Congo, Pakistan and China accounted for nearly 50% of global child deaths in 2010. Targeting efforts in these countries are critical to reducing levels global child mortality.
Child mortality is caused by various factors including poverty, environmental hazards, and lack of maternal education. The World Health Organization creates a list of interventions in the following table that are considered economically and operationally "viable," based on health and infrastructure resources in 42 countries that contribute to 90% of all infant and child mortality. This table shows how much infant and child mortality can be prevented in 2000, assuming universal healthcare coverage.
Prevention methods
Obesity
Obesity is a major risk factor for a wide range of conditions including cardiovascular disease, hypertension, certain cancers, and type 2 diabetes. To prevent obesity, it is recommended that the individual adhere to a consistent exercise regimen as well as a balanced and nutritious diet. Healthy individuals should aim for 10% of their energy from protein, 15-20% from fat, and more than 50% of complex carbohydrates, while avoiding alcohol and high-fat, salt, and sugar foods. Resident adults must achieve at least half an hour of moderate daily physical activity and eventually increase to include at least 20 minutes of intense exercise, three times a week. Preventive health care offers many benefits for those who choose to participate in taking an active role in culture. The medical system in our society is directed to cure the acute symptoms of the disease after the fact that they have taken us to the emergency room. The ongoing epidemic in American culture is the prevalence of obesity. Eating healthy and routinely exercising plays a major role in reducing the risk of individuals for type 2 diabetes. About 23.6 million people in the United States have diabetes. Of those, 17.9 million were diagnosed and 5.7 million were undiagnosed. Ninety to 95 percent of people with diabetes have type 2 diabetes. Diabetes is the leading cause of kidney failure, limb amputation, and new-onset blindness in American adults.
Sexually transmitted infections
In the case of sexually transmitted infections (STIs) such as syphilis health prevention activities will include avoiding microorganisms by maintaining personal hygiene, regular doctor appointments, and general sex education, whereas special protective measures will use prophylaxis (such as condoms) during sex and shrink sexual intercourse. STI is common both historically and in today's society. STIs may be asymptomatic or cause various symptoms. Condom use reduces the risk of contracting some STIs. Other forms of STI prophylaxis include: not performing, testing and checking spouses, routine health checks, and certain medications such as Truvada.
Thrombosis
Thrombosis is a serious circulatory disease that affects thousands of people, usually parents undergoing surgical procedures, women who use oral contraceptives and travelers. The consequences of thrombosis can include heart attacks and strokes. Prevention may include: exercise, anti-embolism stockings, pneumatic devices, and pharmacological treatments.
Cancer
In recent years, cancer has become a global problem. Low- and middle-income countries share the majority of the burden of cancer largely due to exposure to carcinogens resulting from industrialization and globalization. However, the primary prevention of cancer and knowledge of cancer risk factors can reduce more than one third of all cancer cases. Primary cancer prevention can also prevent other diseases, both communicable and non-communicable, sharing common risk factors with cancer.
Lung cancer
Lung cancer is the leading cause of cancer-related deaths in the United States and Europe and is a leading cause of death in other countries. Tobacco is an environmental carcinogen and the main cause of lung cancer. Between 25% and 40% of all cancer deaths and about 90% of lung cancer cases are associated with tobacco use. Other carcinogens include asbestos and radioactive materials. Both smoking and second exposure from other smokers can cause lung cancer and eventually death. Therefore, prevention of tobacco use is very important for the prevention of lung cancer.
Individual, community, and state interventions can prevent or stop tobacco use. 90% of adults in the US who ever smoked did so before the age of 20 years. Prevention/education programs in schools, as well as sources of counseling, can help prevent and stop smoking in teenagers. Other cessation techniques include group support programs, nicotine replacement therapy (NRT), hypnosis, and self-motivated behavioral changes. Studies have demonstrated a 20% long-term success rate (<1 year) for hypnosis and 10% -20% for group therapy.
Cancer screening programs serve as an effective secondary source of prevention. The Mayo Clinic, Johns Hopkins, and the Sloan-Kettering Memorial Hospital perform yearly x-ray examinations and sputum cytology tests and find that lung cancer is detectable at a higher, earlier stage, and has better treatment outcomes, supporting investment extends like a program.
Legislation can also affect smoking prevention and cessation. In 1992, Massachusetts (United States) voters passed a bill adding an extra 25 cents tax for each pack of cigarettes, despite the intense lobbying and $ 7.3 million spent by the tobacco industry to oppose the bill. Tax revenues are used for tobacco education and control programs and have resulted in reduced tobacco use in the state.
Lung cancer and tobacco smoking are increasing worldwide, especially in China. China is responsible for about a third of global consumption and production of tobacco products. Tobacco control policies are ineffective because China is home to 350 million regular smokers and 750 million passive smokers and an annual death toll of more than 1 million. Recommended actions to reduce tobacco use include: reducing tobacco supplies, increasing tobacco taxes, widespread educational campaigns, reducing tobacco advertising, and increasing tobacco cessation support resources. In Wuhan, China, the 1998 school-based program, applying anti-tobacco curriculum to adolescents and reducing the number of regular smokers, though not significantly reducing the number of teens who started smoking. Therefore, the program is effective in secondary prevention but not primary prevention and shows that school-based programs have the potential to reduce tobacco use.
Skin cancer
Skin cancer is the most common cancer in the United States. The most deadly form of skin cancer, melanoma, causes more than 50,000 annual deaths in the United States. Prevention of childhood is very important because most of the exposure to solar ultraviolet radiation occurs during childhood and adolescence and can then cause skin cancer in adulthood. Furthermore, prevention in childhood can lead to the development of healthy habits that continue to prevent cancer for life.
The Centers for Disease Control and Prevention (CDC) recommends some of the main preventive methods including: limiting sun exposure between 10:00 and 16:00, when the sun is strongest, wearing tighter natural cotton clothes, wide caps, and sunglasses for cover, use sunscreens that protect against UV-A and UV-B rays, and avoid tanning salons. Sunscreen should be reapplied after sweating, exposure to water (through swimming for example) or after a few hours of sun exposure. Since skin cancer is highly preventable, the CDC recommends school-level prevention programs including prevention curriculum, family involvement, participation and support of school health services, and partnerships with communities, states, and national institutions and organizations to keep children from excessive UV. radiation exposure.
Most skin cancers and sun protection data come from Australia and the United States. An international study reports that Australians tend to show higher knowledge about sun protection and skin cancer knowledge, compared to other countries. Of children, adolescents, and adults, sunscreen is the most commonly used skin protection. However, many teenagers deliberately use sunscreen with low sun protection factor (SPF) to get brownish skin. Australian studies show that many adults fail to use sunscreen properly; many sunscreens are applied well after their initial sun exposure and/or fail to reapply when necessary. A 2002 case-control study in Brazil showed that only 3% of case participants and 11% of control participants used sunscreen with SPF & gt; 15.
Cervical Cancer
Cervical cancer ranks among the three most common cancers among women in Latin America, sub-Saharan Africa, and parts of Asia. Cervical cytologic examination aims to detect abnormal lesions in the cervix so that women can undergo treatment before the development of cancer. Given that high-quality screening and advanced care have been shown to reduce cervical cancer rates by up to 80%, most developed countries are now encouraging sexually active women to undergo Pap tests every 3-5 years. Finland and Iceland have developed an effective organized program with routine monitoring and have managed to significantly reduce cervical cancer death rates while using fewer resources than unorganized opportunistic programs like those in the United States or Canada.
In developing countries in Latin America, like Chile, Colombia, Costa Rica and Cuba, both public and private programs have offered routine cytology screening to women since the 1970s. However, these efforts have not resulted in significant changes in the incidence of cervical cancer or death in these countries. This may be due to low quality, inefficient testing. However, Puerto Rico, which has offered early checks since the 1960s, has witnessed a nearly 50% decrease in incidence of cervical cancer and nearly fourfold reduction in mortality between 1950 and 1990. Brazil, Peru, India, and some riskier countries Sub-Saharan Africa lacking an organized screening program, has a high incidence of cervical cancer.
Colorectal cancer
Colorectal cancer globally is the second most common cancer in women and the third most common in men, and the fourth most common cause of cancer deaths after lung, stomach, and liver cancer, has caused 715,000 deaths by 2010.
It is also highly preventable; about 80 percent of colorectal cancers begin as benign growth, commonly called polyps, which can be easily detected and eliminated during colonoscopy. Other screening methods for polyps and cancer include occult blood tests. Lifestyle changes that may reduce the risk of colorectal cancer include increasing consumption of whole grains, fruits and vegetables, and reducing the consumption of red meat (see colorectal cancer).
Health gaps and barriers to access care
Access to preventive health care and health services is not the same, as is the quality of care received. A study conducted by the Research and Quality Health Agency (AHRQ) revealed a health gap in the United States. In the United States, older adults (& gt; 65 years) are receiving poorer care and have less access to care than their younger counterparts. The same trend is seen when comparing all racial minorities (black, Hispanic, Asian) with white patients, and low-income people to high-income people. Common barriers to accessing and utilizing health resources include lack of income and education, language barriers, and lack of health insurance. Minorities are less likely than whites to have health insurance, as do individuals who complete less education. This gap makes it more difficult for disadvantaged groups to have regular access to primary care providers, receive immunizations, or receive other types of medical care. In addition, uninsured persons tend not to seek care until their illness progresses to a chronic and serious state and they are also more likely to perform the necessary tests, treatments, and fill prescription drugs.
Such gaps and barriers exist throughout the world. Often, there are decades of gaps in life expectancy between developing and developed countries. For example, Japan has an average life expectancy of 36 years is greater than in Malawi. Low-income countries also tend to have fewer doctors than high-income countries. In Nigeria and Myanmar, there are less than 4 doctors per 100,000 people while Norway and Switzerland have ten times higher ratios. Common obstacles around the world include the lack of availability of health services and health care providers in the region, large physical distances between home and health care facilities, high transportation costs, high maintenance costs, and social norms and stigma on access to health services certain.
Lifestyle-based prevention economy
With lifestyle factors such as diet and exercise rising to the top of preventable mortality statistics, a healthy lifestyle economy is a growing concern. There is little question that a positive lifestyle choice provides an investment in lifelong health. To measure success, traditional measures such as years of quality of life (QALY) methods, show great value. However, the method does not take into account the costs of chronic conditions or future income loss due to poor health. Developing a future economic model that will guide private and public investment and encouraging future policy to evaluate the effectiveness of positive lifestyle choices on health is a key topic for global economists.
Americans spend more than three trillion a year on health care but have higher infant mortality, shorter life spans, and higher rates of diabetes than other high-income countries due to negative lifestyle choices. Despite the enormous cost, very little is spent on prevention for conditions caused by lifestyle as a comparison. The Journal of the American Medical Association estimates that $ 101 billion is spent in 2013 on preventable diabetes, and another $ 88 billion is spent on heart disease. In an effort to encourage healthy lifestyle choices, health programs in the workplace are increasing; but economic data and effectiveness are still growing and evolving.
Health insurance coverage affects lifestyle choices. In a study by Sudano and Baker, even losing lost coverage had a negative effect on healthy choices. The potential revocation of the Affordable Care Act (ACA) can significantly impact coverage for many Americans, as well as "Prevention and Public Health Funds" which are the first and only mandatory funds stream dedicated to improving public health. Also covered by the ACA are counseling on lifestyle prevention issues, such as weight management, alcohol use, and treatment for depression. Policymakers can have a substantial effect on lifestyle choices made by Americans.
Because chronic illness predominates as a cause of death in the US and a pathway to treat complex and diverse chronic diseases, prevention is the best practice approach to chronic diseases whenever possible. In many cases, prevention requires complex mapping of pathways to determine the ideal point for intervention. In addition to efficacy, prevention is considered a cost-saving measure. Preventive cost effectiveness analysis can be achieved, but is influenced by the length of time it takes to see the effects/outcomes of the intervention. This makes prevention efforts difficult to fund - especially in a tense financial context. Prevention has the potential to create other costs as well, as it prolongs life and thereby increases the chances for illness. In order to build a reliable prevention economy for complicated diseases of origin, knowing the best way to assess prevention efforts, that is to develop useful measures and the appropriate scope, is necessary.
Effectiveness
Ikhtisar
There is no general consensus on whether preventive health care measures are cost-effective, but they improve the quality of life dramatically. There are various views on what constitutes "good investment." Some argue that health preventive measures should save more money than costs, when factored into medical expenses in the absence of such measures. Others argue in favor of "good value" or provide significant health benefits even if the measures do not save money. In addition, preventive health services are often described as one entity even though they are made up of different services, each of which can individually lead to the net of fees, savings, or not. A greater differentiation of these services is needed to fully understand the financial and health impacts.
A 2010 study reported that in the United States, vaccination of children, smoking cessation, daily aspirin use, and breast and colorectal cancer screening have the greatest potential to prevent premature death. Preventive preventive health measures include vaccination of children and adults, smoking cessation, daily aspirin use, and screening for problems of alcoholism, obesity, and vision failure. These authors estimate that if the use of this service in the United States increases up to 90% of the population, there will be a net savings of $ 3.7 billion, which accounts for only about -0.2% of total US health care spending in 2006. Although the potential for reducing health care spending, utilization of health resources in the United States remains low, especially among Latinos and African Americans. Overall, prevention services are difficult to implement because health care providers have limited time with patients and should integrate preventive health measures from multiple sources.
Although this particular service generates a small net savings, not all preventive health measures save more than costs. A 1970 study showed that preventing heart attacks by treating hypertension early with drugs actually does not save money in the long run. The money saved by avoiding treatment from heart attacks and strokes only amounted to about a quarter of the cost of drugs. Similarly, it was found that the cost of drugs or dietary changes to lower high blood cholesterol exceeded the cost of further heart disease treatment. Because of these findings, some argue that rather than focusing healthcare reform efforts exclusively on preventive care, interventions that bring about the highest levels of health should be prioritized.
Cohen et al. (2008) outlines some of the arguments made by skeptics about preventive health care. Many argue that precautions cost less than future treatment when the proportion of the population that will become sick without any prevention is substantial. The Diabetes Prevention Research Group conducts a 2012 study evaluating costs and benefits (in QAME-adjusted life years) about lifestyle changes rather than taking metformin medications. They found that no method resulted in financial savings, but was cost effective as they resulted in a QALY increase. In addition to examination costs, skeptics of preventive health care also check the efficiency of interventions. They argue that while many existing disease treatments involve the use of advanced equipment and technology, in some cases, this is a more efficient use of resources than an attempt to prevent disease. Cohen et al. (2008) states that the most worthwhile precautions to be traced and invested are those that can benefit most of the population to produce cumulative and widespread health benefits at a reasonable cost.
- Cost Effectiveness of Childhood Obesity Intervention
There are at least four childhood obesity interventions that are nationally implemented in the United States: Sugar-Scented Beverage Drink (SSB), AD TV programs, active physical education policies (PE Active), and early childhood care and education (PAUD) policies. They each have a similar goal to reduce obesity. The effects of these interventions on BMI have been studied, and cost-effectiveness analysis (CEA) has led to a better understanding of projected cost reductions and better health outcomes. The Childhood Obesity Interventions Cost-Effectiveness Study (CHOICES) was undertaken to evaluate and compare CEAs of these four interventions.
Gortmaker, S.L. et al. (2015) states: "Four initial interventions were selected by researchers to represent scalable national strategies for reducing childhood obesity using a mix of policy and program strategies... 1. an excise tax of $ 0.01 per ounce of sweetened beverage, which applied nationally and administered at the state level (SSB), 2. the abolition of tax deductions on TV advertising costs for "nourishing" foods and beverages seen by children and adolescents (TV AD), 3. state policy requires all (PE), and 4. state policy to make healthier early childhood education arrangements with increase physical activity, improve nutrition, and reduce screen time (ECE). "
The CHOICES found that SSB, TV AD, and ECE led to net cost savings. Both SSB and TV AD improve the quality of life that is adjusted by year and generate annual income taxes of 12.5 billion US dollars and 80 million US dollars, respectively.
Some challenges by evaluating the effectiveness of childhood obesity interventions include:
- The economic consequences of childhood obesity are short and long term. In the short term, obesity interferes with cognitive achievement and academic achievement. Some believe this is secondary to negative effects on mood or energy, but others suggest there may be physiological factors involved. Furthermore, obese children have an increased cost of health care (eg drugs, acute care visits). In the long term, obese children tend to be adults with obesity due to increased risk for chronic conditions such as diabetes or hypertension. Any influence on their cognitive development can also affect their contribution to society and socioeconomic status.
- In OPTIONS, it is noted that translating the effects of these interventions can in fact be different among communities across countries. In addition it is suggested that limited results be studied and these interventions may have additional effects that are not fully appreciated.
- Modeling results in such interventions in children over the long term are challenges as advances in medicine and medical technology are unpredictable. Projections of cost-effective analysis may need to be studied more frequently.
- Economic Prevention Treatment in the US
The cost-effectiveness of preventive care is a highly contentious topic. While some economists argue that preventative maintenance is valuable and potentially cost-effective, others believe it is an inefficient waste of resources. Preventive care consists of various clinical services and programs including annual doctor examinations, annual immunizations, and health programs.
Clinical Preventive Services & amp; Programs
Research on preventive care addresses the question of whether cost-effective or cost-effective and whether there is evidence of economic evidence for health promotion and disease prevention. The need and interest in preventive care is driven by the imperative to reduce health care costs while improving the quality of care and patient experience. Preventive care can lead to improved health outcomes and potential cost savings. Services such as health screening/screening, prenatal care, and telehealth and telemedicine can reduce morbidity or mortality at low cost or cost savings. In particular, health assessments/checks have the potential for cost savings, with varying cost effectiveness based on type of screening and assessment. Inadequate prenatal care can lead to an increased risk of prematurity, stillbirth, and infant mortality. Time is a major resource and preventative care can help reduce time costs. Telehealth and telemedicine are among the choices that have earned interest, acceptance and consumer confidence and can improve the quality of patient care and satisfaction.
Understanding Economics for Investment
There are benefits and trade-offs when considering investments in preventive care versus other types of clinical services. Preventive care can be a good investment as it is supported by evidence base and can drive population health management goals. The concept of cost saving and cost-effectiveness is different and both are relevant for preventive care. For example, preventive care that may not save money can still provide health benefits. Thus, there is a need to compare interventions relative to impacts on health and costs.
Preventive treatments go beyond demographics and apply to people of all ages. The Health Capital Theory underlies the importance of preventive care throughout the life cycle and provides a framework for understanding the differences in health and health care experienced. It treats health as a stock that provides immediate utility. Health depreciates with age and the aging process can be overcome through health investment. This theory further supports that individuals demand good health, that demand for health investment is inherited demand (ie investment is health is due to underlying demand for good health), and the efficiency of the health investment process increases with knowledge (eg assumed that the more educated are more efficient consumers and health producers).
The prevalence of elasticity of demand for prevention can also provide insights into the economy. Demand for preventive care may alter the prevalence of the given disease and further reduce or even reverse the further growth of prevalence. The subsequent reduction in prevalence leads to cost reduction.
Economics for Policy Actions
There are a number of relevant policy organizations and actions when discussing the economics of preventive care services. The evidence base, point of view, and policy summaries of the Robert Wood Johnson Foundation, the Organization for Economic Cooperation and Development (OECD), and efforts by the US Prevention Task Force (USPSTF) all provide examples that improve health and population (eg assessment/examination of preventive health, prenatal care, and telehealth/telemedicine). Patient Protection and Affordable Care Act (PPACA, ACA) have a major impact on the provision of preventive care services, although they are currently being researched and reviewed by the new government. According to the Centers for Disease Control and Prevention (CDC), ACA makes preventive maintenance affordable and accessible through mandatory coverage of preventive services without deductible, copayment, coinsurance, or other cost sharing.
The US Preventive Services Task Force (USPSTF), a national expert panel on prevention and evidence-based medicine, works to improve the health of Americans by making evidence-based recommendations about clinical prevention services. They do not consider the cost of preventive services when determining recommendations. Each year, the organization reports to Congress identifying important research gaps and recommends priority areas for further review.
The National Network of Perinatal Quality Collaboration (NNPQC), sponsored by the CDC, supports nation-based perinatal quality collaboration (PQC) in measuring and improving health and health care outcomes for mothers and infants. These PQCs have contributed to improvements such as reduction of delivery before 39 weeks, reduction in health care related bloodstream infections, and an increase in the utilization of antenatal corticosteroids.
Telehealth and telemedicine have realized significant growth and development recently. The Center for Integrated Health Policy (National Resource Policy Policy Center) has produced many reports and policy summaries on Telehealth and Telemedicine topics and how they contribute to preventive services.
Policy actions and the provision of preventive services do not guarantee utilization. Cost recovery remains a significant barrier to adoption due to differences in payers and country level replacement policies and guidance through government and commercial payers. Americans use prevention services at about half the recommended levels and cost sharing, such as deductibles, co-insurance, or copayments, also reduces the likelihood that preventive services will be used. Further, despite the increase in ACA from the Medicare benefits and prevention services, there is no effect on the utilization of preventive services, calling for the fact that other underlying obstacles exist.
- The Affordable Care Act and Preventive Healthcare
Patient Protection and Affordable Care Act is also known as only the Affordable Care Act or Obamacare passed and became law in the United States on March 23, 2010. The law passed and newly ratified is to address many problems in the US health system, which including coverage extension, insurance market reforms, better quality, and efficiency and cost estimates. Under the insurance market reforms, the act requires that insurance companies no longer exclude persons with pre-existing conditions, allowing children to be covered in their parent plans until the age of 26, extending requests relating to rejection of reimbursement. The Affordable Care Act also prohibits the limited coverage imposed by health insurance and insurance companies including the coverage of preventive health care services. The US Preventive Services Task Force has categorized and rated preventive health services as' 'A' or 'B', such as which insurance companies must comply with and present full coverage. Not only the US Prevention Task Force that provides appropriate preventive health services for coverage, they have also provided many recommendations to doctors and insurance companies to promote better preventive care to ultimately provide better quality care and lower the cost burden.
Health Insurance and Preventive Treatment
Health insurance companies are willing to pay for preventative care despite the fact that patients are not acutely ill with the hope that it will prevent them from developing chronic illness later in life. Currently, health insurance plans offered through the Marketplace, mandated by the Affordable Care Act are required to provide certain preventative care services free of charge to patients. Section 2713 of the Affordable Care Act, stipulates that all private Marketplace and all company-sponsored private plans (excluding those grandfathered) are required to include preventive care services rated A or B by the free Preventive Services Task Force for patients. For example, insurance company UnitedHealthcare has published patient guidance at the beginning of the year explaining the coverage of their preventive care.
Evaluate the Additional Benefits of Preventive Treatment
Evaluating the additional benefits of preventive care takes longer when compared with acute pain patients. Entries into such models, discount rates and time horizons can have significant effects from results. One controversial subject is the use of a 10-year time frame to assess the cost-effectiveness of diabetes prevention services by the Congressional Budget Office.
Preventive care services mainly focus on chronic illness, the Congressional Budget Office has provided guidance that further research in the field of obesity economic impact in the US before the CBO can estimate the budget consequences. The bipartisan report, published in May 2015, recognizes that the potential of preventive care to improve patient health at the individual and population levels while reducing health care spending.
Economic Case for Preventive Health
Mortality of Riskable Factors
Chronic diseases such as heart disease, stroke, diabetes, obesity and cancer have become the most common and costly health problems in the United States. By 2014, it is projected that by 2023 that the number of cases of chronic illness will increase by 42%, generating $ 4.2 trillion in care and loss of economic output. They are also among the top ten causes of death. Chronic illness is driven by risk factors that are largely preventable. Sub-analysis conducted on all deaths in the United States in 2000 revealed that nearly half were associated with preventable behaviors including tobacco, poor diet, physical activity and alcohol consumption. Recent analysis shows that heart disease and cancer alone accounted for almost 46% of all deaths. Modifiable risk factors are also responsible for the large burden of morbidity, resulting in poor quality of life in the present and future future income loss2. It is further estimated that by 2023, efforts to focus on the prevention and treatment of chronic diseases can result in 40 million fewer cases of chronic illness, potentially reducing medical expenses to $ 220 billion.
Child Vaccination Reduces Healthcare Cost
Immunization of children is largely responsible for the improvement of life expectancy in the 20th century. From an economic point of view, childhood vaccines show a very high return on investment. According to People Sehat 2020, for each group of births that received regular childhood vaccination schedules, direct health care costs were reduced by $ 9.9 billion and the public saved $ 33.4 billion in indirect costs. The economic benefits of childhood vaccinations go beyond individual patients to insurance plans and vaccine producers, all while improving the health of the population.
Capital Prevention and Health Theory
The preventable burden of disease extends beyond the health care sector, incurring significant costs associated with loss of productivity among workers in the world of work. Indirect costs associated with poor health behaviors and associated chronic diseases are detrimental to US employers, billions of dollars each year.
According to the American Diabetes Association (ADA), medical costs for employees with diabetes are twice as high for workers without diabetes and are caused by job-related absenteeism ($ 5 billion), reduced workplace productivity ($ 20.8 billion) to work due to illness-related illness ($ 21.6 billion), and premature death ($ 18.5 billion). Estimated cost estimates due to the increasingly high levels of overweight and obese members in the workforce vary, with best estimates showing 450 million lost working days, earning $ 153 billion annually in lost productivity, according to CDC Healthy Workforce.
In the economic field, the Capital Health model explains how individual investments in healthcare can increase incomes by "increasing the number of healthy days available for work and for earning income." In this context, health can be treated both as consumer goods, where individuals want health because of improving the quality of life in the present, and as a good investment because of its potential to increase attendance and productivity in the workplace over time. Preventive health behaviors such as a healthy diet, regular exercise, access to and use of good care, avoidance of tobacco, and limiting of alcohol can be seen as health inputs that result in healthier workforce and substantial cost savings.
Preventive Maintenance and Quality of Adjusted Life
The health benefits of preventive care measures can be explained in terms of the quality of living (QALYs) stored years. QALY considers the length and quality of life, and is used to evaluate the cost effectiveness of medical interventions and prevention. Classically, a year of perfect health is defined as 1 QALY and one year with an inadequate health level given the value between 0 and 1 QALY. As an economic weighting system, QALY can be used to inform personal decisions, to evaluate prevention interventions and set priorities for future prevention efforts.
The cost savings and the effective benefits of preventive maintenance measures are well established. The Robert Wood Johnson Foundation evaluates the library of cost-effectiveness prevention, and finds that many precautions meet the benchmarks & lt; $ 100,000 per QALY and is considered profitable profitably. These include screening for HIV and chlamydia, colon cancer, breast and cervix, vision screening, and screening for menstrual aortic aneurysms in men & gt; 60 in a particular population. Alcohol and tobacco filtering are found to be cost-effective in some reviews and cost-effective elsewhere. According to RWJF analysis, two preventive interventions were found to save costs in all reviews: childhood immunization and adult counseling on aspirin use.
Prevention in Minority Populations
Increased health gaps in the United States for chronic diseases such as obesity, diabetes, cancer, and cardiovascular disease. The population at high risk for health injustice is the growing proportion of racial and ethnic minorities, including African Americans, American Indians, Hispanics/Latinos, Asian Asians, Alaskan Natives and the Pacific Islands.
According to the Racial and Ethnic Approach for Public Health (REACH), the national CDC program, Non-Hispanic blacks currently have the highest rates of obesity (48%), and the risk of newly diagnosed diabetes is 77% higher among non-Hispanic blacks. , 66% higher among Hispanic/Latin and 18% higher among Asian Americans than non-Hispanic whites. Current projected US population estimates that more than half of Americans will become members of minority groups by 2044. Without targeted prevention interventions, the medical costs of chronic disease injustice will become unsustainable. An expanded health policy designed to improve the delivery of prevention services for minority populations can help reduce the huge medical costs caused by injustice in health care, resulting in a return on investment.
Prevention Policy
Chronic illness is a population-level problem that requires the efforts of people's health levels and public policies at the national and state level to effectively prevent, rather than individual-level efforts. The United States currently uses many public health policy efforts that are aligned with the preventive health efforts discussed above. For example, the Control and Prevention Support Center supports initiatives such as Health at All Policies and HI-5 (5 Year Health Impact), a collaborative effort aimed at considering cross-sector prevention and addressing social determinants of health as a primary preventive method for chronic illness. Specific examples of programs that target vaccination and prevention of childhood obesity are discussed in the section to be followed.
Obesity Prevention Policy
Policies that address the epidemic of obesity should be proactive and far-reaching, including multiple stakeholders in both health care and in other sectors. Recommendations from the Institute of Medicine in 2012 show that "... integrated action is taken in and within the five environments (physical activity (PA), food and beverage, marketing and messaging, health care and workites, and schools) and all sectors of society (including government, business and industry, schools, childcare, urban planning, recreation, transportation, media, public health, agriculture, community and home) for obesity prevention efforts really work.
There are dozens of policies currently acting on one (or all) federal, state, local and school level. Most states apply physical education requirements for 150 minutes of physical education per week in schools, the National Association of Sports and Physical Education policies. In some cities, including Philadelphia, sugary food taxes are used. This is part of the amendment to Title 19 of the Philadelphia Code, "Finance, Taxes and Collections"; Chapter 19-4100, "The Sweet Sugar Drinks Tax, approved in 2016, stipulates the excise tax of $ 0.015 per ounce of liquor on a sweetened sweetened beverage distributor both calorie and non-calorie.The distributors are required to file a return with the department, and the department may collect taxes, among other responsibilities.
These policies can be a source of tax credit. For example, under a Philadelphia policy, a business may apply for a tax credit with an earnings department on a first-come, first served basis. This is true until the total amount of credit for a given year reaches one million dollars.
Recently, ads for food and beverages intended for children have gained a lot of attention. The Food and Drink Advertising Initiative (CFBAI) is a self-regulating program of the food industry. Each participating company makes a public appointment detailing its commitment to advertise only foods that meet certain nutritional criteria for children under 12 years old. This is a self-regulated program with policies written by the Council of Better Business Bureaus. The Robert Wood Johnson Foundation funds research to test the efficacy of CFBAI. The results show progress in terms of decreasing food product ads targeting children and adolescents.
To explore other programs and initiatives related to child obesity policy, visit the following organizations and online database: US Department of Agriculture, Disability Bridge Program, Municipal Intermediary and Health Programs Program supported by Robert Wood Johnson Foundation, Yale Rudd Center for Food Policy & amp; Obesity, Centers for Disease Control and Prevention of Chronic Diseases State Policy Tracking Systems, National Legislative Country Conferences, local policy databases ENACT Institute, Organization for Economic Cooperation and Development (OECD), and US Prevention Task Force (USPSTF).
Children's Immunization Policy
Despite national controversies about childhood vaccinations and immunizations, there are federal, state, local and school policies and programs that outline the vaccination requirements. All states require children to be vaccinated against certain infectious diseases as a condition for school attendance. However, currently 18 countries allow exceptions for "philosophical or moral reasons." Diseases in which vaccinations are part of the standard ACIP vaccination schedule are tethusia pertussis diphtheria (whooping cough), poliomyelitis (polio), measles, mumps, rubella, haemophilus influenzae type b, hepatitis B, influenza, and pneumococcal infections. This schedule can be viewed on the CDC website.
The CDC website describes a federally funded program, Vaccine for Children (VFC), which provides cost-free vaccines to children who may not be vaccinated because of the inability to pay. In addition, the Advisory Committee on Immunization Practices (ACIP) is an expert vaccination advisory board that advises on vaccination policies and guides ongoing recommendations to the CDC, incorporating evidence of the latest cost-effectiveness and benefits in its recommendations..
Conclusion of Economic Case
There are economic and health-related arguments for preventive health care. The direct and indirect medical costs associated with preventable chronic diseases are high, and will continue to increase with age and the increasingly diverse US population. Governments, at federal, state, local and school level have recognized this and created programs and policies to support the prevention of chronic diseases, especially in childhood, and focus on preventing obesity and vaccination. Economically, with QALY increase and decreased productivity lost over the lifetime, existing and innovative prevention interventions show high returns on investment and are expected to result in substantial health care cost savings over time.
See also
References
External links
- United States Preventive Services Task Force (USPSTF)
- European Centers for Disease Prevention and Control (ECDC)
Source of the article : Wikipedia
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