Preventive Services Not Being Utilized

Between 50,000 to 100,000 deaths occur each year while millions of dollars are wasted on caring for conditions that could have been avoided, according to a report by the Centers for Disease Control and Prevention, the first in a series that will look at preventive care.

Health insurers offer a benchmark for how prevention should be handled, states “Rationale for Periodic Reporting on the Use of Selected Adult Clinical Preventive Services — United States,” published in the CDC’s Morbidity and Mortality Weekly Report (http://1.usa.gov/z4V5Wo [1]).

“The health-related costs of underuse of recommended clinical preventive services are substantial,” the report states. “Researchers have reported that increasing use of nine clinical preventive services to more optimal levels (i.e., levels achieved by high-performing health plans) could prevent an estimated … annual loss in life expectancy for the U.S. population as a whole of approximately two million years.”

CDC Director Thomas R. Frieden, MD, MPH, wrote, “Tens of millions of people in the United States have not been benefiting from key preventive clinical services, and … there are large disparities by demographics, geography, and health care coverage and access in the provision of these services.”

The report, using data collected before 2010, finds that:

• Slightly fewer than half of patients with heart disease are prescribed aspirin or other antiplatelet agents.
• Slightly less than half of patients with high blood pressure had it under control.
• Only two thirds of adults had had their cholesterol levels checked during the preceding five years.
• More than one third of outpatient visits had no documentation of tobacco use status. “Rates of counseling were particularly low among younger smokers, despite a high level of interest in quitting in this population; younger smokers have been shown to be more likely to try to quit but less likely to succeed, hence could benefit particularly from improved counseling and treatment.”
• About 2.3 million diabetics had poor glycemic control.
• About 1 in 5 women between 50 and 75 had not had a mammogram during the preceding two years.
• One third of people between 50 and 75 were not up to date with screening for colorectal cancer.
• About 1 in 5 of the 1.1 million people in the United States living with HIV have not been diagnosed.
• About 1 in 4 of people 65 and younger were vaccinated against influenza; 133 million adults were not vaccinated.