New England Journal of Medicine · 1977 · 272 citations · 1 references
MedicineHealth PolicyPreventive MedicineDisease PreventionEarly DetectionHealth InsuranceCoverage Decision-makingDisease Prevention PolicyPrevention StrategiesPreventive CarePreventive Health CarePreventive Services CoverageGonococcal OphthalmiaHealth Care EconomicsHealth MonitoringPediatric Health PolicyPreventive Care BenefitsPreventive Control MeasuresPreventive Screening PolicySpecific Goals
Current health‑care patterns and financing require improvement through cost‑effective, health‑effective preventive measures. The authors propose a Lifetime Health‑Monitoring Program that uses clinical and epidemiologic criteria to set specific health goals and services for ten age groups. The program prescribes age‑specific preventive actions, such as seven immunizations and developmental screenings in infancy, and hypertension, cancer, obesity, and smoking controls for ages 40‑59. The program’s preventive costs are modest and should be covered by insurance, and integrating prevention into routine care is expected to strengthen patient‑physician relationships.
Current patterns of health care and its financing need to be improved by the incorporation of cost-effective and health-effective preventive measures. As a stimulus for further development, we propose a Lifetime Health-Monitoring Program that uses clinical and epidemiologic criteria to identify specific health goals and professional services appropriate for 10 different age groups. During infancy, for example, we recommend seven immunizations, tests to detect anemia, hemorrhagic diseases, phenylketonuria and developmental deficiencies, and routine prophylaxis of gonorrheal ophthalmia. In the age group 40 to 59, tests for hypertension, cervical, mammary, and gastrointestinal cancer, and control of obesity and smoking are in order. The cost of such preventive measures. which should not be prohibitive, must be covered by health-insurance programs, whether based on fee-for-service or capitation. The program suggested, by incorporating prevention into day-to-day care, should strengthen the patient-physician relation.
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From the New York Times Magazine
Minsky, Paul Hyman · 1979 · 6.9K citations