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Benefits of Health Care Prevention

by Anna Cearley
Dana Goldman
Dana Goldman

A study overseen by USC professor Dana Goldman provides support for preventive measures – such as exercise or dietary changes – as a cost-effective way to improve the health and life spans of elderly patients with certain chronic conditions.

The study, published in the American Journal of Public Health, found that Americans over the age of 50 who are being treated with diabetes, hypertension or obesity interventions could live longer, with better quality of life, and without increasing lifetime medical spending.

For example, a person between the ages of 51 and 52 who was being treated through preventive methods for diabetes could live an additional 3.17 years, with an overall lifetime savings in medical costs of $34,483. The study also found longevity gains and overall savings were linked to preventive or intervention treatment for obesity and hypertension.

“The health care reform debate has focused on health insurance expansions and cutting payment rates,” said Goldman, director of the USC-based Leonard D. Schaeffer Center for Health Policy and Economics. “This study demonstrates how prevention can improve population health without raising costs.”

Goldman was supervisor of the research project and lead author of the report, “The Benefits of Risk Factor Prevention in Americans Aged 51 Years and Older,” which was published in November. Other co-authors were Yuhui Zheng, Federico Girosi, Pierre-Carl Michaud, Jay Olshansky, David Cutler and John W. Rowe.

The researchers used a demographic and economic simulation model developed by Goldman and other researchers called the Future Elderly Model, which is designed to predict the health status and future costs of older populations. The model has been the basis of several other studies led by Goldman to examine the costs of cancer, obesity, chronic disease and disability in older populations.

Support for the Future Elderly Model has come from several sources, including the National Institute on Aging and the MacArthur Research Network on an Aging Society.

In the American Journal study, the researchers extended the model to include a larger cohort from the Health and Retirement Study, a biennial survey started in 1992 of Americans who are over the age of 50. Additional data was drawn from the Medicare Current Beneficiary Survey and the Medical Expenditure Panel Survey.

While cost benefits were identified in intervention methods for diabetes, hypertension and obesity, that was not the case with smoking. The researchers found that those who quit smoking could add up to 3.44 years to their life span. However, smoking cessation – because it resulted in such longer life expectancy – could cost an additional $15,959 over an individual’s lifetime.

In 2009, Goldman joined USC, where he holds the Norman Topping Chair in Medicine and Public Policy in the School of Policy, Planning, and Development and is also a professor with the School of Pharmacy.

He directs the newly formed USC-based Leonard D. Schaeffer Center for Health Policy and Economics, which is conducting research and policy analysis to support evidence-based health care reform.

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