Friday, August 24, 2012

[EQ] The Cost-Effectiveness of Environmental Approaches to Disease Prevention

The Cost-Effectiveness of Environmental Approaches to Disease Prevention

Dave A. Chokshi,and Thomas A. Farley

From Brigham and Women’s Hospital and Harvard Medical School
 — both in Boston (D.A.C.), and the New York City Department of Health and Mental Hygiene, New York (T.A.F.).

N Engl J Med 2012; 367:295-297July 26, 2012

Website: http://bit.ly/QzPJCd

“…..How can society prevent the most disease and deaths per dollar spent? This question arose throughout the debate on U.S. health care reform and will continue to drive decision making as health care funding becomes increasingly constrained. In an atmosphere of austerity, demonstrating the cost-effectiveness of preventive health interventions becomes particularly important.

Although preventive approaches to disease are intuitively appealing — and frequently presented as a way to reduce costs — analyses have suggested that, as a whole, they're no more cost-effective than therapeutic interventions.1 But are some preventive approaches more cost-effective than others?

The National Commission on Prevention Priorities attempted to address this question, ranking clinical preventive services in terms of cost-effectiveness and “clinically preventable burden” of disease.2 Yet some preventive services, such as tobacco taxes or water fluoridation, are not delivered in health care settings. Understanding whether certain approaches are more cost-effective than others requires a framework for categorizing preventive interventions.

Medicine traditionally classifies preventive interventions on the basis of disease course: primary prevention aims to prevent new cases of disease; secondary prevention and tertiary prevention mitigate the effects of existing disease. We propose two overlapping dimensions to further characterize primary preventive interventions: environmental versus person-directed, indicating whether the proximate target is an element of the environment or an individual, and clinical versus nonclinical, indicating where an intervention takes place…..”

 

KMC/2012/SDE
Twitter
http://twitter.com/eqpaho

 *      *     *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]
Washington DC USA

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------
PAHO/WHO Website
Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
Twitter http://twitter.com/eqpaho




IMPORTANT: This transmission is for use by the intended
recipient and it may contain privileged, proprietary or
confidential information. If you are not the intended
recipient or a person responsible for delivering this
transmission to the intended recipient, you may not
disclose, copy or distribute this transmission or take
any action in reliance on it. If you received this transmission
in error, please dispose of and delete this transmission.

Thank you.

No comments: