NCPA - National Center for Policy Analysis


December 7, 2006

David Cutler, Mary Beth Landrum, and Kate Stewart studied disability caused by cardiovascular disease to investigate the role of improved medical care on reductions in disability.  By looking at just one condition, they can analyze health shocks and their outcomes in some detail.  Cardiovascular disease is a natural condition to analyze, because it is the most common cause of death in the United States and most other developed countries. Also, more is spent on cardiovascular disease than on any other condition, clearly a case where medical care could really matter.

  • Cutler and his co-authors find that reduced disability associated with cardiovascular disease accounts for a significant part of the total reduction in disability - between 14 and 22 percent.
  • The evidence suggests that improvements in medical care, including both increased use of relevant procedures and pharmaceuticals, led to a significant part of this decline in disability.
  • Regions with higher use experienced substantial reductions in mortality and disability.

While precise data on the implications of reduced disability are lacking, the possible impact of disability reductions is staggering:

  • The authors estimate that preventing disability after an acute cardiovascular event can add as much as 3.7 years of quality-adjusted life expectancy, or perhaps $316,000 of value.
  • The cost of this outcome is significantly smaller; the initial treatment costs range from $8,610 to $16,332, depending on the procedure used.
  • Further, recent cost analyses reported that annual Medicare spending was lower for the non-disabled than the disabled, which suggests that higher treatment costs may be offset by lower future spending among a more healthy population.

By virtually any measure, therefore, the authors conclude that medical technology after acute cardiovascular episodes is worth the cost.

Source: Les Picker, "Intensive Care Reduces Disability after Cardiovascular Disease," NBER Digest, December 2006; based upon: David Cutler, Mary Beth Landrum, and Kate Stewart, "Intensive Medical Care and Cardiovascular Disease Disability Reductions," National Bureau of Economic Research, Working Paper No. 12184, May 2006.

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