Friday, November 2, 2012

Annual checkups and the overconsumption of healthcare

Naomi Freundlich has a terrific post on annual checkups:
It sounds like heresy, but recent evidence challenges the long-held belief that the annual physical is beneficial for healthy adults. Researchers at the Nordic Cochrane Center in Copenhagen wrote last week that although a regular check-up with multiple screening tests might seem to offer the advantage of catching problems like heart disease and cancer early, their review of studies involving some 180,000 adults actually found no benefit. People who had annual check-ups were no less likely to be admitted to the hospital, become disabled or miss work than those who did not have regular physicals. Even more surprising, they were no less likely to die from heart disease, cancer or any other illness.
The study's authors offer a compelling theory for why this might be the case:
In fact, subjecting healthy adults to this yearly battery of tests may do more harm than good. The authors write, “One possible harm from health checks is the diagnosis and treatment of conditions that were not destined to cause symptoms or death. Their diagnosis will, therefore, be superfluous and carry the risk of unnecessary treatment.”
I'm increasingly starting to believe that overconsumption of healthcare is a bigger issue than previously realized.

Looking at the minimal differences in longevity between rich and poor countries only strengthens this theory.  We spend much more on healthcare than many middle-income countries, but receive very similar results in life expectancy.  The U.S. spends $7,000/person on health; Mexico spends $800.  But U.S. life expectancy is only two years longer than Mexico's (78.2 in U.S. versus 76.2 in Mexico).  And that's despite the fact that violence and traffic accidents kills 7% of Mexico's population versus only 3% in the U.S.

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