A Financial Case for Public Health
Pay now or pay later. States face this choice every day, particularly with how and when they invest in clinical preventive health services leading to prevention and reduced economic burden in terms of length of hospital stay and general health care costs.
The rewards of paying now are better known than ever before. Research has demonstrated that supporting healthy early childhood development–from before through age 5–generates substantial educational, social and financial benefits for individuals, families and communities.
A major study, The High Costs of Failing to Invest in Young Children produced by Partnership for America’s Economic Success, highlighted that the price society pays when a single person experiences child abuse, drops out of high school, or abuses alcohol can range up to tens to thousand dollars over that person’s lifetime. The study’s purpose was to help policy makers and the public fully evaluate the consequences of their present funding decisions.
The latest RWJ/University of Wisconsin County Health Ranking (CHR) revealed that morbidity numbers are rather low in Lehigh County (37 out of 67 counties) and Northampton County (a shocking 60 out of 67). Morbidity is a term that refers how healthy people feel in the community while alive and it captures the Birth Outcomes along with Health-related quality of life (HRQoL) within the community. Birth Outcomes are measured using low birth weight (LBW) that represents child’s current and future morbidity. Low birth weight is reported to be higher in both Lehigh Valley (8.3%) and Northampton County (8.7%) as compared to the State average of 8.2% and way higher than the national average of 6.0%, according to CHR report.
It was mentioned in the blog on County Health Ranking Across Pennsylvania that the public health spending in Pennsylvania is extremely low as compared to other states in U.S. In this context of scarce resources, the advantage of economic analysis is that helps substantiate present action in terms of investing in prevention and public health. Such an analysis helps providers in managing an individual’s health and administrators in appropriately focusing resources, and — moreover — illustrates the return on investment (ROI) for public health initiatives. According to a study in Western New York, a positive ROI was demonstrated for a prenatal program developed at the Managed Care Organization using a model of economic analysis.
In general clinical preventive services are cost-effective; some are cost-saving. Some clinical preventive services prevent disease or injury (e.g. cervical cancer screening); some preventive services catch disease in early stages when treatment is most effective and least expensive (e.g. STI screening). Because clinical preventive services can prevent or reduce the need for treatment, they provide a cost-offset. Lehigh County has the highest number of sexually transmitted infection rates as compared to state or national average, according to CHR report. Key studies have been done that support the cost-offset value of prevention.
Below are the examples of cost-offset of clinical preventive services recommended in the Plan Benefit Model conducted as part of study that provides rationale to our current work on establishing a regional health department for Lehigh Valley. Of particular note is the cost offset by screening for Chlamydia and Sexually Transmitted Diseases (STDs). Screening for gonorrhea and Chlamydia allows for early recognition of diseases that could prevent the costly implications of late stage complication such as Pelvic Inflammatory Disease (PID). The average life-time cost of PID and its major complications for women have been estimated to be in the range of 1,060-6,840 US dollars. Check out the image below for details on how investment in prevention saves financial resources over the long term.