Preventive care: do we practice what we preach?

Lurie, Nicole; Manning, Willard G.; Peterson, Christine E.; Goldberg, George A.; Phelps, Charles E.; Lillard, Lee A.

doi:10.2105/ajph.77.7.801

Cited by 192 publications

(69 citation statements)

References 11 publications

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“…First, most have used crosssectional study designs (Blustein, 1995;Liang et al, 2004;Solanki & Schauffler, 1999), which do not allow inferences about causation to be made. Second, most samples have been composed of either non-elderly individuals enrolled in private health insurance plans (Lurie et al, 1987;Solanki & Schauffler, 1999) or elderly beneficiaries enrolled in Medicare managed care plans (Trivedi et al, 2008). As a result, the findings of such studies may not be generalizable to elderly Medicare beneficiaries enrolled in the FFS program, because of differences in the ages of the samples and the cost sharing requirements of the plans.…”

Section: E17mentioning

confidence: 99%

“…Other studies have compared preventive service use among individuals who did and did not have a copayment (Lurie et al, 1987;Solanki & Schauffler, 1999;Trivedi et al, 2008), who did not have a copayment then did have a copayment, or whose copayment increased (Trivedi et al, 2008). One study compared preventive service use among beneficiaries with and without supplemental insurance [because most supplemental plans cover Medicare's Part B deductible and coinsurance] (Blustein, 1995), which is a proxy for cost sharing.…”

Section: E18mentioning

confidence: 99%

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Effect of Cost-Sharing Reductions on Preventive Service Use Among Medicare Fee-for-Service Beneficiaries

Goodwin¹,

Anderson²

2011

MMRR

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Section: E17mentioning

confidence: 99%

Section: E18mentioning

confidence: 99%

Effect of Cost-Sharing Reductions on Preventive Service Use Among Medicare Fee-for-Service Beneficiaries

Goodwin¹,

Anderson²

2011

MMRR

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“…56,101,110,116,146,152,155 Details of the 19 qualifying studies are provided at the website: http:// web.health.gov/communityguide. Of the qualifying studies, 14 evaluated the effectiveness of reducing out-of-pocket costs regarding improving vaccination outcomes 28,30,35,67,71,76,108,[147][148][149][150]153,156,158 ; four evaluated the effectiveness of these interventions regarding improving provider-reported likelihood of referring clients elsewhere for vaccinations, 145,151,154,159 and one evaluated both vaccination and referrals. 157 Of the studies evaluating vaccination outcomes, seven evaluated reducing out-of-pocket costs as a singlecomponent intervention, and eight evaluated multicomponent interventions that included reducing outof-pocket costs.…”

Section: Reducing Out-of-pocket Costsmentioning

confidence: 99%

Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults11The names and affiliations of the Task Force members are listed on page v of this supplement and at http://www.thecommunityguide.org22Some of this material was published previously in: Shefer A, Briss P, Rodewald L, et al. Improving immunization coverage rates: an evidence-based review of the literature. Epidemiol Rev 1999;20:96–142.

Briss

Rodewald

Hinman

et al. 2000

American Journal of Preventive Medicine

467

103

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Background: This paper presents the results of systematic reviews of the effectiveness, applicability, other effects, economic impact, and barriers to use of selected population-based interventions intended to improve vaccination coverage. The related systematic reviews are linked by a common conceptual approach. These reviews form the basis for recommendations by the Task Force on Community Preventive Services (the Task Force) regarding the use of these selected interventions. The Task Force recommendations are presented on pp. 92-96 of this issue. Medical Subject Headings (MeSH):vaccine-preventable diseases, vaccination coverage, community health services, decision-making, evidence-based medicine, systematic reviews, population-based interventions, practice guidelines, preventive health services, public health practice, task force. Introduction V accine-preventable diseases among children, adolescents, and adults represent major continuing causes of morbidity and mortality in the United States. During the latter half of the twentieth century, the success of childhood vaccination programs in the United States has led to a Ͼ95 % decline in most vaccine-preventable diseases of childhood. However, Ͼ400,000 cases of illness and Ͼ30,000 deaths caused by vaccine-preventable diseases still occur each year 1 (CDC unpublished data).Diphtheria, invasive Haemophilus influenzae type b (Hib) disease, measles, poliomyelitis, rubella, tetanus, mumps, varicella, and pertussis are typically referred to as vaccine-preventable diseases of childhood. Vaccinations primarily indicated for adults include influenza, pneumococcal, and hepatitis B. However, during the 1990s, the distinction between childhood and adult vaccine-preventable diseases became less clear. Many childhood vaccine-preventable infections, including measles and pertussis, are found increasingly among adults, 2,3 and hepatitis B vaccinations are now routinely recommended for infants and adolescents. Table 1 outlines universally recommended (i.e., vaccinations recommended for most or all persons in certain age groups) vaccinations for children, adolescents, and older adults.In children, Ͼ50,000 cases of varicella occur each year, making that disease the most common vaccinepreventable disease among children 4 ; in adults, influenza, pneumococcal disease, and hepatitis B are all still common vaccine-preventable diseases, with hundreds of thousands of cases occurring each year.5 Mortality attributable to vaccine-preventable diseases is still substantial. Each year, approximately 500 persons in the United States die of childhood vaccine-preventable diseases, and Ͼ30,000 adults die of influenza, pneumococcal infections, and hepatitis B.1 Influenza, which accounts for an average of 20,000 deaths/year, is usually the largest killer. 5The effectiveness of universally recommended vaccinations in preventing disease for adults, adolescents, and children is well-established. 6 -14 In addition to protecting individuals from diseases passed from person to person contact, vaccinat...

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“…Protected from the true costs of medical care, the incentives to prevent illness from occurring in the first place are reduced. Under these circumstances, even relatively modest logistical barriers may detain people from seeking appropriate preventive care, even if that care is available at no cost (Lurie et al 1987).…”

Section: External Costs and Societal Welfarementioning

confidence: 99%

Countervailing Agency: A Strategy of Principaled Regulation under Managed Competition

Schlesinger

1997

Milbank Quarterly

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Despite the failure of recent attempts to reform health care, strategies of managed competition remain the dominant prescription for government oversight of managed care. A number of assumptions and prescriptions in the conventional managed competition model are challenged. More specifically, externalities in the costs and benefits associated with health care and asymmetric information between providers and patients make it unlikely that a managed care system designed to be responsive to consumers will, in practice, produce socially desirable outcomes. An alternative approach for the regulation of managed care more explicitly protects the role of health care professionals as agents for their patients while defining the appropriate role of managed care as the agent for broader societal interests. This strategy of “countervailing agency”acknowledges that oversight of managed care inevitably involves value‐laden choices. It is based on institutional arrangements and regulatory strategies that are intended to balance competing interests and values.

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Preventive care: do we practice what we preach?

Cited by 192 publications

References 11 publications

Effect of Cost-Sharing Reductions on Preventive Service Use Among Medicare Fee-for-Service Beneficiaries

Effect of Cost-Sharing Reductions on Preventive Service Use Among Medicare Fee-for-Service Beneficiaries

Countervailing Agency: A Strategy of Principaled Regulation under Managed Competition

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