Don't Expect Investments in Health To Save Money (Except in Schizophrenia)

Spending money on education, tests, and treatments to prevent expensive
illnesses such as heart disease and stroke saves money overall, right? Wrong,
according to a report in a recent issue of the British Medical Journal.

Such preventive efforts also increase life span -- and thus
increase costs for medical care in later life, noted
researchers from the Netherlands. In other words,
preventing disease is clearly beneficial in humanitarian terms
-- but don't expect it to be cost effective.

"The aim of prevention is to spare people from avoidable
misery and death not to save money on the healthcare
system," reported Dr. Luc Bonneux and colleagues from the
Department of Public Health at Erasmus University in
Rotterdam.

"Elimination of fatal disease -- such as coronary heart
disease, cancer or chronic obstructive lung disease --
increases healthcare costs," they wrote. "Major savings will
be achieved only by elimination of non-fatal diseases -- such
as musculoskeletal diseases and mental disorders."

The researchers came to the conclusion by looking at the
lifetime healthcare costs in 1988 for Dutch men and women.
The life expectancy was 73.5 years for men, resulting in a
lifetime cost of 56,600 British pounds (roughly
US$92,500). The life expectancy was 80 years for women,
for a lifetime cost of 80,000 pounds (about US$132,000).

Coronary heart disease caused 19% of deaths, but were
responsible for only 2.7% of treatment costs incurred in a
lifetime. On the other hand, psychiatric disorders were
extremely costly.

"Mental disorders, including psychiatric diseases, mental
handicaps and dementia are together responsible for only
0.6% of all deaths but account for 26% of the allocated
healthcare budget," the authors wrote.

 SOURCE: British Medical Journal
(1998;316:26-29)