Lifetime costs for preventive medical services: a model.

BACKGROUND: Cost effectiveness and other issues relating to preventive health services have been widely discussed, but a computer search of the literature elicited no reports in which the lifetime cost of a patient's preventive services was calculated. The purpose of our study was to calculate the total lifetime cost of preventive medical services for idealized versions of male and female patients. METHODS: We used the preventive screening recommendations of the US Preventive Services Task Force as our standard. We developed a model using idealized patients who were asymptomatic, had no risk factors, and lived healthful lifestyles. We determined the typical charges in a specified marketplace for the office visits, procedures, laboratory tests, and purchases required to comply with the screening recommendations. RESULTS: Lifetime charges ranged from $5432.60 to $7529.60 for men and from $15,307.10 to $18,525.10 for women. CONCLUSIONS: Knowledge of the lifetime costs of preventive services may influence the decisions of patients, physicians, and insurance plans when purchasing or providing these services.

Do tobacco companies avoid proper use of warnings in magazine ads?

By law, cigarette advertisements in magazines must contain one of four surgeon general's warnings and these warnings must be rotated quarterly. This study surveyed the top 13 magazines by paid subscription in the United States that accept cigarette advertising to determine if cigarette companies are compliant with this law. All issues of these magazines published during 1990 were surveyed yielding 1329 ads. Goodness of fit chi-square was used to compare observed distributions of each warning with the expected distribution. There were no significant differences in the number of times each warning appeared over the year or in each magazine. The tobacco industry as a whole appears to follow the guidelines of the Comprehensive Smoking Education Act, though 2 of 6 companies and 8 of 32 brands appear to advertise more heavily when using certain warnings and less heavily when other warnings are utilized.