All AHPP News News February 3, 2021

Health Signals Increase Preventive Care, Improve Health Outcomes for Individuals at High Risk of Diabetes, Evidence from Japan Shows

Among the general population, however, researchers including Asia Health Policy Program Director Karen Eggleston find no evidence that additional care improves health outcomes.
Male Japanese doctor showing senior patient records on a clipboard
TommL via Getty

The information age has made it much easier to access one’s own health data. From health screenings at pharmacy retail locations to increasingly popular wearable technologies, people have multiple ways to gain insights into their physical activity and health beyond the traditional channels of health checkups and workplace wellness programs. But does such health information lead to appropriate preventive care, improve health outcomes, and ultimately reduce medical spending?

In a new study published by the Journal of Public Economics, a group of researchers including Karen Eggleston, deputy director of APARC and the director of its Asia Health Policy Program, provide evidence on this question.

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Eggleston and her co-authors set out to investigate the marginal value of information in the context of health signals that people receive after routine checkups. Their study focuses on the risk for diabetes, a costly and incurable chronic disease of growing prevalence that makes a primary prevention target. Using rich longitudinal data from Japan, where health checkups are mandatory, Eggleston and her colleagues look at whether checkup results indicating risk of developing diabetes affect individuals’ medical care utilization, health behaviors, and health outcomes. They also examine whether the additional care triggered by exceeding a clinical threshold is worth its cost.

While many governments and organizations emphasize the importance of preventive care, not all such care can improve welfare. False alarms may lead to low-value diagnostic procedures, some of which may even increase risk of complications.
Karen Eggleston et al

The researchers find that some people do respond to health signals by undertaking follow-up visits with physicians, and therefore these health signals can potentially promote preventive care. Despite the significant increase in medical care utilization, however, for the general population — whether at the pre-diabetes threshold or among those classified as a diabetic type — there is no evidence that the additional care improves health outcomes as measured by a variety of biomarkers. Only among high-risk individuals with elevated blood pressure and high cholesterol do the researchers find evidence that health outcomes improve and that improved health is worth its cost.

These results indicate that health signals can improve welfare if thresholds are set appropriately and follow-up medical care targets those at the highest risk. They also demonstrate the need to provide evidence showing that policies and programs that emphasize preventive care can improve health outcomes cost-effectively. “While many governments and organizations emphasize the importance of preventive care,” the researchers argue, “not all such care can improve welfare. False alarms may lead to low-value diagnostic procedures, some of which may even increase risk of complications.”

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A woman has blood drawn at a clinic in Bombay, India
News

How to Prevent Diabetes and Other Chronic Diseases Cost-Effectively

Addressing the epidemic of chronic diseases in India and other low- and middle-income countries requires comprehensive evidence on the cost-effectiveness of health interventions, argue APARC’s Asia Health Policy Program Director Karen Eggleston and Postdoctoral Fellow Radhika Jain.