Table 3.
QALYs Saved if Utilization Rates Increase Above Current Levels
| Services (Short Name)a | Source | Currently Receiving Services Nationallyb % | Additional QALY Saved if Currently Receiving Services Increased to 90%c |
|---|---|---|---|
| Services with utilization data available | |||
| Tobacco use counseling to prevent initiation by youthd | Jamal23 | 20 | 530,000 |
| Tobacco use screening and brief cessation intervention, adults | NCQA24 Jamal25 King26 |
50 | 460,000 |
| Alcohol misuse screening, brief intervention | McKnight-Eily27 | 10 | 140,000 |
| Colorectal cancer screening | CDC28 | 65 | 110,000 |
| Influenza immunization, adults | CDC29 | 45 | 100,000 |
| HPV immunizationd | Reagan-Steiner30 | 50 | 59,000 |
| Breast cancer screening | NCHS31 CDC28 |
75 | 42,000 |
| Chlamydia and gonorrhea screeningd | CDC32 | 40 | 39,000 |
| HIV screening | Chandra33 | 20 | 32,000 |
| Aspirin chemoprevention for those at higher risk of CVD | Williams34 | 50 | 30,000 |
| Cervical cancer screening | NCHS31 CDC28 |
85 | 14,000 |
| Vision screening, children | Kemper35 | 75 | 5,000 |
| Pneumococcal immunization, adults | CDC28 | 70 | 4,000 |
| Services with utilization data assigned at 50% | |||
| Obesity screening, adultse | Assigned | 50 | 540,000 |
| Healthy diet counseling for those at higher risk of CVDe | Assigned | 50 | 300,000 |
| Obesity screening, children and adolescentsd,e | Assigned | 50 | 78,000 |
| Depression screening, adultse | Assigned Farr36 Edwards37 |
50 | 45,000 |
| AAA screeninge | Assigned Shreibati38 |
50 | 21,000 |
| Depression screening, adolescentsd,e | Assigned | 50 | 11,000 |
| Syphilis screeninge | Assigned | 50 | 2,000 |
AAA = abdominal aortic aneurysm; CDC = Centers for Disease Control and Prevention; CMS = Centers for Medicare & Medicaid Services; CPS = Community Preventive Services; CVD = cardiovascular disease; FDA = Food and Drug Administration; HIV = human immunodeficiency virus; HPV = human papillomavirus; QALY = quality-adjusted life years; USPSTF = US Preventive Services Task Force.
See Table 2 for a description of each service. Childhood immunizations, hypertension screening, and cholesterol omitted from table because of current high utilization rates.
Current utilization rates rounded and reflect approximate average of male and female patients, across all relevant age-groups and other important groups for a service, such as groups at high and low risk for disease.
Indicates additional lifetime QALYs saved if 90% of a cohort of 4 million were offered service as recommended.
Youth services estimated based on a target of 90% of youth receiving service annually, although slightly less than 90% of adolescents aged 12–17 years saw a health care professional in 2012.
Based on limited utilization data. Utilization data were considered limited if existing information was difficult to use to quantify utilization rates and place an upper boundary more precise than 50%. Either utilization data are completely lacking or are available only for a population for which generalizability to US population is highly questionable, or the utilization measures available are poorly aligned with the preventive service as recommended by the USPSTF.