Table 5:
Net Value of Medical Care, 1999–2012
| Spending Change | QALE Change | Value of a Year of Life | Discount rate | |||
|---|---|---|---|---|---|---|
| Condition | $100,000 | $50,000 | $200,000 | (3%) | ||
| Overall (95% confidence interval, 000s) |
$57,893 ($46–$69) |
1.70 (0.7–2.5) |
$112,575 ($14–$188) |
$27,341 ($-18–$64) |
$283,042 ($87–$440) |
$66,220 ($0–$116) |
| Cardiovascular diseases | $5,157 | 0.94 | $89,327 | $42,085 | $183,811 | $56,731 |
| Ischemic heart disease | $5,054 | 0.86 | $80,888 | $37,917 | $166,830 | $51,361 |
| Congestive heart failure | $13,569 | 0.35 | $21,395 | $3,913 | $56,358 | $12,042 |
| Other heart and vascular disease | −$1,573 | 0.41 | $43,058 | $22,316 | $84,543 | $27,848 |
| Strokes and cerebrovascular disease | $4,354 | 0.45 | $40,750 | $18,198 | $85,855 | $25,588 |
| Cardiovascular risk factors | $15,439 | 0.22 | $6,995 | −$4,222 | $29,429 | $2,289 |
| Cancers | −$80 | 0.38 | $37,987 | $19,033 | $75,895 | $23,821 |
| Lung cancer | $24,099 | 0.36 | $12,384 | −$5,857 | $48,868 | $8,994 |
| Colorectal cancer | −$2,196 | 0.36 | $38,275 | $20,235 | $74,353 | $24,610 |
| Prostate cancer | $9,211 | 0.02 | −$7,374 | −$8,292 | −$5,537 | −$6,918 |
| Breast cancer | $1,272 | 0.18 | $16,470 | $7,599 | $34,213 | $9,041 |
| Other cancers and neoplasm | −$2,423 | 0.37 | $39,116 | $20,770 | $75,809 | $24,909 |
| Mental Health | $5,568 | 0.15 | $4,397 | −$493 | $14,175 | $3,126 |
| Dementia | $6,355 | 0.11 | $ 4,725 | −$815 | $15,805 | $1,672 |
| Mental health and tobacco/drug abuse | $4,343 | 0.14 | $3,519 | −$307 | $11,170 | $3,020 |
| Central Nervous System (CNS) | $3,446 | 0.05 | $1,591 | −$927 | $6,629 | $729 |
| Major disease of the CNS | $4,213 | 0.10 | $5,305 | $546 | $14,822 | $3,155 |
| Eye, ear, other disease of the CNS | $1,484 | 0.00 | −$1,197 | −$1,341 | −$911 | −$955 |
| Respiratory System | $3,815 | 0.10 | $6,553 | $1,369 | $16,921 | $3,535 |
| Respiratory symptoms, COPD, asthma | $3,828 | 0.20 | $15,789 | $5,981 | $35,406 | $9,397 |
| Infectious disease | $1,082 | −0.12 | −$13,404 | −$7,243 | −$25,726 | −$8,687 |
| Kidney Disease | $7,286 | 0.01 | −$5,796 | −$6,541 | −$4,307 | −$4,722 |
| Chronic renal failure or ESRD | −$645 | 0.13 | $13,281 | $6,963 | $25,917 | $8,844 |
| Acute renal failure | $11,009 | 0.41 | $29,783 | $9,387 | $70,575 | $19,183 |
| Other genitourinary disease | $6,520 | −0.06 | −$12,826 | −$9,673 | −$19,132 | −$9,386 |
| Frailty | $4,168 | 0.27 | $22,615 | $9,224 | $49,399 | $14,458 |
| Musculoskeletal | $14,172 | 0.11 | −$2,792 | −$8,482 | $8,589 | −$2,061 |
| Arthritis and musculoskeletal | $14,416 | 0.17 | $2,304 | −$6,056 | $19,024 | $1,355 |
| Injury | $1,375 | −0.08 | −$9,204 | −$5,290 | −$17,033 | −$6,194 |
| Endocrine, GI, Liver, Hematologic | $10,012 | 0.23 | $13,146 | $1,567 | $36,304 | $6,977 |
| Other endocrine | $5,525 | 0.21 | $15,553 | $5,014 | $36,631 | $9,287 |
| Gastrointestinal and liver disease | $2,836 | 0.08 | $5,325 | $1,245 | $13,485 | $2,767 |
| Hematologic | $10,616 | 0.08 | −$2,543 | −$6,580 | $5,531 | −$2,963 |
| Miscellaneous | $10,660 | 0.03 | −$7,280 | −$8,970 | −$3,900 | −$5,934 |
| After care | $14,564 | 0.06 | −$8,486 | −$11,525 | −$2,407 | −$6,685 |
| General symptoms and other disease | $4,365 | 0.01 | −$3,680 | −$4,023 | −$2,994 | −$3,110 |
| Prevention and screening | −$2,557 | 0.02 | $4,261 | $3,409 | $5,964 | $3,024 |
| Immunizations and infectious screening | −$134 | 0.01 | $949 | $541 | $1,763 | $580 |
| Cancer screening | −$519 | −0.03 | −$2,437 | −$959 | −$5,393 | −$1,369 |
| Well care | −$4,975 | 0.05 | $10,425 | $7,700 | $15,876 | $7,188 |
Notes: In the first row, spending change uses the present value of expected lifetime costs for each disease per person in the population, and QALE change uses expected QALE at age 65 for each disease per person in the population. In subsequent rows, results are per person with the disease (or disease category). The discount rate is 0% in the columns varying the value of a year of life. The value of a year of life is $100,000 in the column varying the discount rate.
Source: Authors’ calculations as described in text.