Prevention and Cost Control

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Science  21 Sep 2012:
Vol. 337, Issue 6101, pp. 1433
DOI: 10.1126/science.1229493

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Prevention is the key to cost control and improving the quality of health care in many nations. Most people think of prevention as vaccines and screening tests. But it is tertiary prevention—keeping people with established diseases from becoming worse—that holds the greatest promise for strengthening the health care system. Why? Health care costs are unevenly distributed across populations. In the United States, 50% of the population uses hardly any health care, whereas 10% consumes nearly two-thirds of all health care spending. The latter are patients with one or more chronic conditions, such as congestive heart failure, diabetes, or cancer. To control costs, we must prevent the conditions of this 10% of patients from worsening.