       Document 0880
 DOCN  M9620880
 TI    The cost of comprehensive preventive medical services for adolescents.
 DT    9602
 AU    Gans JE; Alexander B; Chu RC; Elster AB; Department of Adolescent
       Health, American Medical Association,; Chicago, Ill, USA.
 SO    Arch Pediatr Adolesc Med. 1995 Nov;149(11):1226-34. Unique Identifier :
       AIDSLINE MED/96049016
 AB    OBJECTIVES: To address the need for clinical preventive services for 11-
       to 21-year-old males and females and provide cost estimates for those
       services under a fee-for-service system. Preventive services include
       screening, health promotion, and immunizations. DESIGN: The prevalence
       of adolescent morbidities was derived from national surveys. Estimated
       costs of these morbidities were obtained from published data and
       adjusted for 1992 dollars using the Consumer Price Index. The estimated
       costs of preventive services for adolescents under a fee-for-service
       system were derived from a 1993 survey of nine Blue Cross and Blue
       Shield plans and four insurance companies. MAIN OUTCOME MEASURES: The
       cost of adolescent morbidities includes only direct medical costs for a
       single year and excludes long-term and indirect costs. The cost of
       clinical preventive services is calculated at 100% participation levels.
       RESULTS: Each year, an estimated $33.5 billion is spent on medical
       treatment for select adolescent morbidities, approximately $859 per
       adolescent per year; this is a conservative estimate. The average cost
       of clinical preventive services per adolescent per year would be
       approximately $130 in a fee-for-service system, although these are not
       entirely new costs because payers already incur screening costs for some
       conditions. CONCLUSION: The cost-effectiveness of clinical interventions
       for various health risk behaviors among adolescents is unknown. It
       appears that preventive interventions would have to eliminate 15% of
       adolescent morbidities overall to break even in economic terms.
 DE    Accidents, Traffic/PREVENTION & CONTROL  Acquired Immunodeficiency
       Syndrome/PREVENTION & CONTROL  Adolescence  Adolescent
       Medicine/*ECONOMICS  Alcoholism/PREVENTION & CONTROL  Child
       Comprehensive Health Care/*ECONOMICS/UTILIZATION  Female  Health
       Promotion  Health Surveys  Human  HIV Seropositivity/TRANSMISSION
       Immunization  Male  Mental Health Services/STANDARDS/UTILIZATION
       Pregnancy  Pregnancy in Adolescence  Preventive Health
       Services/*ECONOMICS/UTILIZATION  Risk-Taking  Sexually Transmitted
       Diseases/PREVENTION & CONTROL  Support, Non-U.S. Gov't  JOURNAL ARTICLE
       REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

