Deaths Preventable in the US by Improvements in Use of Clinical Preventive Services
Deaths Preventable in the US by Improvements in Use of Clinical Preventive Services
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DOI：
10.1016/j.amepre.2010.02.016
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发表时间：
2010-06-01
影响因子：
5.5
通讯作者：
Frieden, Thomas R.
中科院分区：
文献类型：
--
作者：
Farley, Thomas A.;Dalal, Mehul A.;Frieden, Thomas R.
背景资料：医疗保健改革计划是指提高质量，但有一个质量care.Purpose的潜在健康效益的量化：本文旨在估计更多地使用临床预防service.Methods的健康效益：两个数学模型被开发出来，以估计潜在的死亡人数，每年通过增加使用9个临床预防服务。一个模型估计所有原因造成的可预防死亡，另一个模型估计特定类别原因造成的可预防死亡。模型的基础是对建议采取干预措施的危险因素的流行率、这些危险因素对死亡率的影响、干预措施对高危人群死亡率的影响以及目前和可实现的干预措施利用率的估计。这两个模型都预测，通过更多地利用预防服务，预防心血管疾病的服务增加最多。例如，全因模型预测，在老年人中，高血压治疗每增加10%将导致额外14，000例死亡预防，而低密度脂蛋白胆固醇升高治疗或阿司匹林预防每增加10%将导致8000例死亡预防。
Background: Healthcare reform plans refer to improved quality, but there is little quantification of potential health benefits of quality care.Purpose: This paper aims to estimate the health benefits by greater use of clinical preventive services.Methods: Two mathematical models were developed to estimate the number of deaths potentially prevented per year by increasing use of nine clinical preventive services. One model estimated preventable deaths from all causes, and the other estimated preventable deaths from specific categories of causes. Models were based on estimates of the prevalence of risk factors for which interventions are recommended, the effect of those risk factors on mortality, the effect of the interventions on mortality in those at risk, and current and achievable rates of utilization of the interventions.Results: Both models predicted substantial numbers of deaths prevented by greater use of the preventive services, with the greatest increases from services that prevent cardiovascular disease. For example, the all-cause model predicted that every 10% increase in hypertension treatment would lead to an additional 14,000 deaths prevented and every 10% increase in treatment of elevated low-density lipoprotein cholesterol or aspirin prophylaxis would lead to 8000 deaths prevented in those aged