Putting healthcare dollars into the 'right' prevention services

Although an "ounce of prevention" has always been better than a "pound of cure," it has been difficult to marshal the health care establishment to make the investment in preventive services, or to concentrate their attention on those areas where the most benefit is gained for each dollar invested.

A series of articles and commentaries in the July issue of the American Journal of Preventive Medicine address the need to channel resources into those areas of preventive care which will benefit the most people for each dollar spent.

Former Surgeon General of the United States David Satcher, MD, chaired the National Commission on Prevention Priorities, which guided the approach used to rank these services. He writes, "Our intent was to identify preventive services that produce the greatest population health benefit and cost effectiveness in order to help inform decision makers at multiple levels about which preventive services are most valuable." Dr. Satcher emphasizes that the evidence-based studies in this issue "provide fascinating insights on the most valuable clinical preventive services."

Continuing the theme, Samuel R. Nussbaum, MD, of WellPoint, Inc., a major healthcare benefits company, writes, "One of the most effective approaches we can take in both the public and private sectors is to direct more attention and more resources to preventive health services. The challenge, however, for providers, payers, and policymakers, is determining the most beneficial preventive services in a resource-constrained environment. The reality is that some health services are emphasized at the expense of others, and decisions are often based on practice experience versus evidence-based science and rigorous comparative analyses. Too often, medical services of unproven value usurp the resources that could be used to provide preventive services."

Steven H. Woolf, MD, MPH, addresses this issue in more detail. He writes, "Under conditions of limited tim


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