Although treatment costs are approximately twice as high for respondents receiving appropriate treatments, these costs may be offset by lower yearly spending in subsequent years among survivors. A previous study of 1982 and 1984 NLTCS respondents found annual per capita spending by Medicare for respondents without any ADL or IADL limitations was approximately $3,275, compared to $7,400 for respondents with at least 4 ADL and 5 IADL impairments and $13,100 for institutionalized respondents. These data suggest that the costs of intensive medical treatments that prevent or delay disability may be offset by lower annual average spending among healthier beneficiaries.
More recent studies using the Medicare Current Beneficiary Survey found similar lifetime spending between non-disabled and disabled 70 year olds (Lubitz, Cai et al. 2003), but life expectancy was approximately 2.7 years longer among the non-disabled (Lubitz, Cai et al. 2003). This provides further evidence that average annual spending may be lower among the non-disabled relative to the disabled. However, another recent study found spending on the nondisabled is growing faster than spending on the disabled (Chernew, Goldman et al. 2005). Whether increased spending on intensive medical care treatments, such as those for cardiovascular disease, continues to increase life expectancy and reduce average annual yearly spending among the non-disabled relative to the disabled will require further investigation.
Examining disability associated with cardiovascular disease leads to several important results. Reduced disability associated with cardiovascular disease accounts for a significant part of the total reduction in disability – between 19 and 22 percent. The evidence suggests that improvements in medical care, including both increased use of relevant procedures and pharmaceuticals, led to a significant part of this decline. Areas with higher use experienced substantial reductions in mortality and disability. natural breast enhancement pill
While precise data on the implications of reduced disability are lacking, the possible impact of disability reductions is staggering. We estimate that preventing disability after an acute event can add as much as 3.7 years of quality-adjusted life expectancy, or perhaps $316,000 of value. The cost of this change is much smaller. The initial treatment costs range from $8,610 to $16,332, depending on procedure use. Further, recent cost analyses reported that annual Medicare spending was lower for the non-disabled compared to the disabled, which suggests that higher treatment costs may be offset by lower future spending among a more healthy population. By virtually any measure, therefore, medical technology after acute cardiovascular episodes is worth the cost.
The major issue raised by our results is whether these conclusions extend to other conditions. Disability reductions are complex, and will certainly involve medical as well as nonmedical factors. Sorting these out for other conditions is a high priority for future research.