Societal Expenditure on Prevention

Abstract Introduction In 2015, Dutch healthcare expenditure exceeded 85 billion euros. But what about prevention? In this study we estimated national expenditure on prevention. A distinction was made between health protection, health promotion and disease prevention. In the estimation of prevention expenditures, this study is limited to universal, selective and indicated prevention, as healthcare-related prevention can hardly be distinguished from curative care. This study analyzed expenditure on preventive activities in the Netherlands in 2015 and took a societal perspective. Methods We used various sources to investigate spending on prevention in 2015. Insofar as costs were part of healthcare expenditure, estimates were based on the Care Accounts of Statistics Netherlands. For the remainder, we estimated expenditure using annual reports and annual accounts of governments and other organizations. We included preventive activities by consumers, industry, NGOs, insurance companies, and government. Results In 2015, an estimated € 12.4 billion (1.8% of the GDP) was spent on prevention: € 2.4 billion on disease prevention (19%), € 0.6 billion on health promotion (5%) and € 9.4 billion on health protection (76%). This is a decrease of 17% compared to 2007, the last year that a similar estimate was made. Within health promotion, the largest expenditure was for working conditions and safety: € 160 million. € 67 million was spent on mental disorders. The largest expenditure item within disease prevention was dental care: € 675 million. Within health protection, this was the sewer by more than € 3 billion. Conclusions Spending on prevention is relatively low compared to total spending on healthcare. The largest part is targeted at health protection. In the coming years there may be an increase in expenditure, due to more governmental prevention policies such as the National Prevention Agreement. Key messages Spending on prevention is relatively low compared to total spending on healthcare. Relatively little money for health protection.

Download Full-text

Evaluation of the effects of a new integrated health management service model on p eople with risk factors for dyslipidemia

10.21203/rs.3.rs-48897/v2 ◽

2020 ◽

Author(s):

Rui Zhang ◽

Shuang Wang ◽

Yi-Ni He ◽

Bin Wu ◽

Ying Wu ◽

...

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Health Promotion ◽

Health Literacy ◽

Disease Prevention ◽

General Practitioners ◽

Health Management ◽

Health Protection ◽

Management Services

Abstract Background: Dyslipidemia is a factor that affects the occurrence and development of many chronic diseases. With its prevalence increasing each year, dyslipidemia has caused substantial disease and economic burdens in China and around the world. Appropriate health management is imperative for people with risk factors for dyslipidemia. We established a new model of health management services (integration of general practice and personalized disease prevention in health management, IGPDP) to more appropriately manage people with risk factors for dyslipidemia. Methods: The experiment was conducted in Shenyang, Liaoning Province, China. We selected 5 administrative districts with populations of more than 100,000. Twenty-three community health service centers with a daily average of more than 50 outpatients were selected. A total of 5,032 subjects with risk factors for dyslipidemia who met the inclusion criteria were included in this study. Using prospective cohort study methods, the subjects were followed up for 24 months. The subjects were randomly divided into the control and test groups, and they received traditional health management services or IGPDP. We analyzed and compared changes in disease prevention, health protection, and health promotion between the two groups.Results: In terms of disease prevention, we found that after the intervention, subjects' behavioral risk factors (smoking habits, diets, sedentary lifestyles) and health literacy improved. In terms of health protection, we observed a decrease in Body mass index (BMI), a gradual improvement in blood lipid levels, and an overall increase in quality of life scores. In terms of health promotion, after the intervention, the proportion of the subjects who were willing to accept the contracted services of general practitioners increased.Conclusion: IGPDP can effectively cultivate healthy lifestyles, improve health literacy, reduce biological risk factors, decrease risk of dyslipidemia, and improve quality of life of subjects. IGPDP is conducive to improving the quality of the service of general practitioners, increasing the trust of the general public, and facilitating the establishment of a hierarchical medical system.

Download Full-text