Objective: To compare performance of one-time health interventions to those that change the probability of transitioning from one health state to another. Study Design and Setting: We used multi-state life table methods to estimate the impact of eight types of interventions on several outcomes. Results: In a cohort beginning at age 65, curing all the sick persons at baseline would increase life expectancy by 0.23 years and increase years of healthy life by .54 years. An equal amount of improvement could be obtained with a 12% decrease in the probability of getting sick, a 16% increase in the probability of a sick person recovering, a 15% decrease in the probability that a sick person dies, or a 14% decrease in the probability that a healthy person dies. Interventions aimed at keeping persons healthy increased longevity and years of healthy life, while decreasing morbidity and medical expenditures. Interventions focusing on lowering mortality had a greater effect on longevity, but increased morbidity and future medical expenditures. Results differed by the age at baseline and the relative value of a year of sick life. Conclusions: Some, but not all, interventions can improve survival while reducing morbidity and medical expenditures.
Disease Modeling | Epidemiology | Health Services Research | Vital and Health Statistics
Diehr, Paula; Newman, Anne B.; Cai, Liming; and Derleth, Ann, "Different Public Health Interventions have Varying Effects" (February 2006). UW Biostatistics Working Paper Series. Working Paper 279.