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Research Outline
Prepared for Juan M. | Delivered September 17, 2019
Healthcare Outlook - Genes, Environment, and Lifestyle
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Goals
To obtain insights on how genes, the environment, and lifestyle will impact future health costs for the purposes of creating a presentation.
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Early Findings
Preliminary research indicates that genes, the environment, and lifestyle currently have a major impact on health costs and will continue to do so in the future unless interventions are made.
GENES
According to a research study published in Nature, "pediatric inpatients with diagnostic codes linked to genetic disease have a significant and disproportionate
impact on resources and costs
in the US health-care system." This suggests that genetic diseases will continue to cost more than other health issues.
Patients with suspected genetic diseases are "
high utilizers
of health care" and correspond to an additional
$12,000 to $77,000
per discharge compared with people who do not have genetic diseases.
Overall, patients with indications of genetic disease "showed a mean incremental total cost per discharge of
$13,999
, suggesting that more complex cases result in higher health-care utilization."
Of pediatric discharges in 2012,
2.6% to 14%
were for genetic disease, but the costs associated with those discharges represented
11% to 46%
of the pediatric "
national bill
."
While gene therapy could potentially "positively affect millions of lives," they are expected to be "
costly
, particularly if they are administered as single or short-term treatments, and are likely to pose major affordability challenges."
Health budgets of public insurers are already strained and "based on the initial pricing experience with gene therapy in Europe, should a growing number of gene therapies come into use at costs of US$1–2 million, the cumulative budget impact would be very substantial, and
perhaps unsustainable.
"
Even if cost savings with gene therapy are realized over time by preventing long-term care, "the health system will be confronted with the challenge of absorbing upfront treatment prices over
US$1 million
per patient for even a relatively small number of patients."
ENVIRONMENT
A 2018 study indicated that there will be
2.5 million
cases of non-communicable diseases associated with air pollution by 2035, which makes "air pollution an important
public health priority
."
Air pollution is currently the "leading environmental cause of early death—contributing to the equivalent of
5%
of all deaths globally and an estimated
40,000
premature deaths each year in the UK."
In the UK, healthcare costs related to air pollution are estimated to be between
£8.5 billion and £20.2 billion
per year.
In 2015, "diseases caused by air, water and soil pollution were responsible for
9 million
premature deaths, that is
16%
of all global death."
Almost all of these deaths (
92%
) were in poorer nations, but the global financial costs of pollution are estimated at
$4.6 trillion
per year.
LIFESTYLE
U.S. health care costs for chronic diseases such as heart disease, cancer, diabetes, and Alzheimer’s reached $1.1 trillion in 2016.
The lifestyle factors of being overweight or obese accounted for
47%
of the total chronic health care costs, while
8.7%
was attributed to cigarette smoking, and
1%
was attributed to excessive alcohol drinking.
As of 2015, nearly
40%
of Americans are considered obese and another
33%
are considered overweight. Research has "established a strong link between
obesity and chronic diseases
such as heart disease, kidney disease, and several types of cancers."
The Partnership to Fight Chronic Disease estimates that
83 million
Americans will have three or more chronic conditions by 2030.
A 2017 study found that healthy lifestyles lead to an
increased utilization
of preventive health services, and did not show a significant decrease in outpatient visits.
According to the Centers for Disease Control and Prevention, in 2010,
86%
of all healthcare spending "went toward people with one or more chronic conditions."
The
Complete Health Improvement Program
(CHIP), which is an initiative that promotes a health lifestyle, reduced outpatient medical visits of participants between
11% and 25%
over a year when implemented as a workplace program.
According to Steve Burd, founder and CEO of Burd Health, indicated he was able to lower his company's healthcare costs by
40%
and cut employees' costs by
10%
with the implementation of "voluntary, company-wide wellness initiatives that provided monetary incentives for maintaining healthy lifestyles."
A study funded by the
National Dairy Council
found that increasing Americans' adherence to healthy diet patterns by 20% could "
save more than $20 billion
in direct and indirect costs."
Meal delivery programs like Meals on Wheels
reduce the healthcare costs
in Medicare and Medicaid beneficiaries.
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