Even as some groups are advocating reducing preventive services, the American Medical Association says that much of the additional expenses associated with health care could be curbed by taking steps to keep chronic diseases under control.
“Healthy People 2010” is a set of health objectives for the nation.
“Nearly half of Americans are living with often-preventable chronic diseases that limit their quality of life and cost the U.S. health care system billions of dollars a year to treat,” said Edward Langston, board member for the AMA. “Keeping up with screenings and immunizations can help detect and prevent many of these health problems early on.”
About 75 percent of health care spending in the United States is linked to chronically ill patients. The AMA wants to work with local health departments, public schools, community programs and businesses to curb chronic diseases through preventive health care services — particularly for people aged 50 to 64.
By 2015, one in every five Americans will be between the ages of 50 and 64, and 70 percent will have at last one chronic condition. Half will have two or more.
Despite the availability of preventive services — and their relatively inexpensive costs — doctors say few people take advantage of them.
“Not one state is meeting the U.S. Health and Human Services goal for influenza and pneumonia vaccinations,” Langston said. “Considering the availability, affordability and safety of these vaccines, we can and we must do better than we are doing now.”
The AMA wants to strengthen the links between health care and community providers to focus actions and build awareness to make services accessible and convenient.
In the first of a series of reports about the problem, the AMA encourages more physical activity, expanding tobacco cessation programs and policies, and promoting effective environmental strategies for binge drinking prevention. It also wants to develop and promote policy recommendations to enhance clinical preventive service delivery during the next three years.
Data from the Behavioral Risk Factor Surveillance System sets the starting line for states, and the AMA will monitor the progress during the next few years.
Some of the programs include:
WiseWoman, a Centers for Disease Control and Prevention-sponsored program that instills lasting, healthy lifestyle changes in women at risk for heart disease, stroke and other chronic disease.
Sickness Prevention Achieved through Regional Collaboration, or SPARC, which builds partnerships to increase the delivery of clinical preventive services.
The Family Heart Study, directed by Johns Hopkins University, which delivered multiple preventive services in a community setting to adults at risk for cardiovascular disease.
The focus is 50-64 age group because research shows that preventive services can decrease chronic disease and their effects.
For example, routine mammograms for women in that age brackets have been shown to significantly reduce deaths from breast cancer. Healthy working adults who receive flu vaccinations report significantly fewer episodes of respiratory illness, fewer days of sick leave and fewer visits to the doctor. Screening and counseling for tobacco use can help life-long smokers quit, reduce blood pressure and increase life spans.
However, despite the fact that doctors have recommended preventive screenings for decades, they are underused. During 2002, fewer than one in four adults aged 50 to 64 received a core set of the services.
“The costs of recommended immunizations, screening and early detection, and counseling are far less than the expense of treating disease,” the report said. “Early detection of breast cancer can save up to 35 percent of the net cost of treatment and follow up care, and screening for colorectal cancer for adults ages 50 and above was rated as one of the highest ranked preventive services, with the lowest delivery costs.”
Amy Gillentine covers health care for the Colorado Springs Business Journal.