Does prevention save costs? Considering deferral of the expensive last year of life

被引:42
作者
Gandjour, A [1 ]
Lauterbach, KW [1 ]
机构
[1] Univ Cologne, Inst Hlth Econ & Clin Epidemiol, Cologne, Germany
关键词
cost-effectiveness; model; statistical; prevention;
D O I
10.1016/j.jhealeco.2004.11.009
中图分类号
F [经济];
学科分类号
02 ;
摘要
Published cost-effectiveness analyses may overstate the cost-effectiveness ratio of preventive care if they do not explicitly model the costs of the last year of life, which is postponed by prevention. To determine the degree of overestimation, the authors built a statistical model using Medicare expenditure data on survivors and decedents. The model shows that the cost-effectiveness ratio of prevention may decrease by up to US$ 11,000 per quality-adjusted life year saved when expenditure data on the last year life are used. The model is able to explain more than half of the median cost increase of published cost-effectiveness analyses on clinical preventive services. (c) 2005 Elsevier B.V. All rights reserved.
引用
收藏
页码:715 / 724
页数:10
相关论文
共 18 条
  • [1] Adler G S, 1994, Health Care Financ Rev, V15, P153
  • [2] Why is less money spent on health care for the elderly than for the rest of the population? Health care rationing in German hospitals
    Brockmann, H
    [J]. SOCIAL SCIENCE & MEDICINE, 2002, 55 (04) : 593 - 608
  • [3] Priorities among recommended clinical preventive services
    Coffield, AB
    Maciosek, MV
    McGinnis, JM
    Harris, JR
    Caldwell, MB
    Teutsch, SM
    Atkins, D
    Richland, JH
    Haddix, A
    [J]. AMERICAN JOURNAL OF PREVENTIVE MEDICINE, 2001, 21 (01) : 1 - 9
  • [4] AGING, NATURAL DEATH, AND THE COMPRESSION OF MORBIDITY
    FRIES, JF
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1980, 303 (03) : 130 - 135
  • [5] Medicare beneficiaries' costs of care in the last year of life
    Hogan, C
    Lunney, J
    Gabel, J
    Lynn, J
    [J]. HEALTH AFFAIRS, 2001, 20 (04) : 188 - 195
  • [6] Medical expenditures during the last year of life: Findings from the 1992-1996 Medicare Current Beneficiary Survey
    Hoover, DR
    Crystal, S
    Kumar, R
    Sambamoorthi, U
    Cantor, JC
    [J]. HEALTH SERVICES RESEARCH, 2002, 37 (06) : 1625 - 1642
  • [7] Incorporating future costs in medical cost-effectiveness analysis: Implications for the cost-effectiveness of the treatment of hypertension
    Johannesson, M
    Meltzer, D
    OConor, RM
    [J]. MEDICAL DECISION MAKING, 1997, 17 (04) : 382 - 389
  • [8] KUNTZ K, 2002, EC EVALUATION HLTH C, P141
  • [9] EXERCISE INTENSITY AND LONGEVITY IN MEN - THE HARVARD ALUMNI HEALTH STUDY
    LEE, IM
    HSIEH, CC
    PAFFENBARGER, RS
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1995, 273 (15): : 1179 - 1184
  • [10] Influence of age on medicare expenditures and medical care in the last year of life
    Levinsky, NG
    Yu, W
    Ash, A
    Moskowitz, M
    Gazelle, G
    Saynina, O
    Emanuel, EJ
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 286 (11): : 1349 - 1355