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Understanding recent increases in chronic disease treatment rates: more disease or more detection?

Published online by Cambridge University Press:  01 October 2010

David H. Howard ,
Kenneth E. Thorpe  and
Susan H. Busch
David H. Howard*
Affiliation:
Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA
Kenneth E. Thorpe
Affiliation:
Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA
Susan H. Busch
Affiliation:
Division of Health Policy and Administration, Yale School of Public Health, Yale University, New Haven, CT, USA
*
*Correspondence to: David Howard, Department of Health Policy and Management, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA. E-mail: david.howard@emory.edu
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Abstract

The proportion of the population treated for major medical conditions, including diabetes, cancer and mental illness, increased rapidly during the 1990s. We document the magnitude of these increases and use a model of prevalence to identify three potential causes: increased clinical incidence of disease, longer survival times among persons with chronic illnesses and increased detection. We present a series of analyses to evaluate the contribution of each factor. We find that increases in obesity explain a large proportion of the increase in treatment rates for conditions closely linked to obesity (e.g. diabetes). We provide some evidence that increases in treated prevalence unexplained by changes in the underlying clinical incidence of disease are driven by increased detection and treatment of patients with ‘subclinical’ illness.

Type
Articles
Information
Health Economics, Policy and Law , Volume 5 , Issue 4 , October 2010 , pp. 411 - 435
Copyright
Copyright © Cambridge University Press 2010

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