When
it comes health care we should plan "focus on prevention:
wellness not sickness", Many studies shows that primary and
preventive care greatly reduces future health care costs, as well as
increasing patients health.
Indeed,
some evidence does suggest that there are opportunities to save money
and improve health through prevention. Preventable causes of death,
such as tobacco smoking, poor diet and physical inactivity, and
misuse of alcohol have been estimated to be more deaths in our
countries. Sweeping statements about the cost-saving potential of
prevention, however, are overreaching. Studies have concluded that
preventing illness can in some cases save money but in other cases
can add to health care costs. For example, screening costs will
exceed the savings from avoided treatment in cases in which only a
very small fraction of the population would have become ill in the
absence of preventive measures. Preventive measures that do not save
money may or may not represent cost-effective care (i.e., good value
for the resources expended). Whether any preventive measure saves
money or is a reasonable investment despite adding to costs depends
entirely on the particular intervention and the specific population
in question. For example, drugs used to treat high cholesterol yield
much greater value for the money if the targeted population is at
high risk for coronary heart disease, and the efficiency of cancer
screening can depend heavily on both the frequency of the screening
and the level of cancer risk in the screened population.
The
focus on prevention as a key source of cost savings in health care
also sidesteps the question of whether such measures are generally
more promising and efficient than the treatment of existing
conditions. Researchers have found that although high-technology
treatments for existing conditions can be expensive, such measures
may, in certain circumstances, also represent an efficient use of
resources. It is important to analyze the costs and benefits of
specific interventions.
Findings
that some cost-saving or highly efficient measures are underused
would indicate that current practice is inconsistent with the
efficient delivery of health care. Other services might be identified
as overused, and such findings would underscore the importance of
fashioning policies that provide incentives to shift practice toward
more cost-effective delivery of health care. In the face of
increasingly constrained resources, there is a realistic way of
achieving better health results:
conduct
careful analysis to identify evidence-based opportunities for more
efficient delivery of health care — whether prevention or
treatment.
Restructure
the system to create incentives that encourage the appropriate
delivery of efficient interventions.