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Preventive care: do we practice what we preach?

N Lurie, W G Manning, C Peterson

    American Journal of Public Health
    |July 1, 1987
    PubMed
    Summary
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    Insurance coverage significantly impacts preventive care uptake. Even with free care, recommended preventive services remain underutilized, indicating cost sharing is not the sole barrier to adequate healthcare.

    Area of Science:

    • Health Services Research
    • Preventive Medicine
    • Health Economics

    Background:

    • Preventive care services are crucial for population health.
    • Insurance coverage is hypothesized to influence the utilization of preventive services.

    Purpose of the Study:

    • To assess the receipt of selected preventive care components in the US non-aged population.
    • To determine the role of insurance coverage in the utilization of preventive care.

    Main Methods:

    • Analysis of insurance claims from the Rand Health Insurance Experiment.
    • Examination of preventive care utilization across different insurance coverage plans (free vs. cost-sharing).

    Main Results:

    • Low rates of timely infant immunizations (45%) and adult tetanus shots (4%).

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  • Significant disparities in Pap smear and mammogram uptake among women.
  • Cost-sharing plans were associated with reduced preventive care utilization compared to free plans.
  • Even free care plans did not ensure adequate preventive care uptake.

    • Conclusions:

    • Insurance coverage is a determinant of preventive care, but not the sole factor.
    • Free care alone is insufficient to achieve recommended levels of preventive services.
    • Additional incentives or interventions are needed to improve preventive care rates.