It seems very logical that getting people to adopt healthy lifestyles–eat a good diet, get enough exercise, manage stress, avoid high-risk activities like smoking, drug use or too much alcohol intake–will both lower health spending and improve ultimate health outcomes. One expensive chronic condition is diabetes, which also can have an impact on the cardiovascular health of patients. Research reported in the New England Journal of Medicine suggests that an intensive lifestyle intervention for these patients did not improve cardiovascular outcomes. (NEJM Article) Analyzing over 5000 overweight patients with diabetes and following them for a very long period, a program of diet control and exercise was successful in producing greater weight loss, better glycemic control, better all-around fitness and better control of most cardiovascular risk factors, but was unsuccessful in reducing death from cardiovascular causes, nonfatal heart attacks, nonfatal stroke or hospitalizations for chest pain. The intervention patients also received significant counseling and support from providers. The loss of weight and the other improvements in health undoubtedly are important and almost certainly improve the quality of life for these patients. And the researchers did not compute economic outcomes, but you would suspect health utilization and spending was lower for the intervention group, perhaps enough to outweigh the cost of the intervention. It is unclear why rates of cardiovascular events were not different; perhaps more weight loss is needed or perhaps the control group had enough weight loss and health improvement to reduce their risks. But these interventions should not be abandoned just because they don’t appear to change some outcomes; they have other benefits that are worth pursuing.
✅ Subscribe via Email
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
Healthy Skeptic Podcast
This is an outstanding report on total global drug spending and trends, with projections out to 2025. It helps you understand this important area of health care, which does much...
June 1, 2021
MedPAC 2019 Report to Congress
June 18, 2019
Mercer, a large benefits consulting firm, confirms that health plan premiums are rising in 2023, publishing survey results showing that employers expect an increase of costs by at least 5%....
December 9, 2022
More money pouring into young health care companies as Dispatch Health gains $330 million in new capital to deliver high acuity health care in a patient’s home, rather than a...
November 30, 2022
A lot of money is invested in health care startups and growth companies, since health care is 20% of the economy, but the returns aren’t always good. Here is another...
November 1, 2022
Access ACO Care Management Chronic Disease Comparative Effectiveness Consumer Directed Health Consumers Devices Disease Management Drugs EHRs Elder Care End-of-Life Care FDA Financings Genomics Government Health Care Costs Health Care Quality Health Care Reform Health Insurance Health Insurance Exchange HIT HomeCare Hospital Hospital Readmissions Legislation M&A Malpractice Meaningful Use Medicaid Medical Care Medicare Medicare Advantage Mobile Pay For Performance Pharmaceutical Physicians Providers Regulation Repealing Reform Telehealth Telemedicine Wellness and Prevention Workplace