Access to Health Care Has Little Impact on Longevity

 Health care has modest effects on extending life expectancy in the United States, while behavioral and social determinants may have larger effects, according to a review published in the May/June issue of the Annals of Family Medicine.

Robert M. Kaplan, Ph.D. and Arnold Milstein, M.D., M.P.H., both from Stanford University in California, examined four different methods of estimating the effect of health care on health outcomes: (1) analyses by McGinnis and Schroeder; (2) Wennberg and colleagues' studies of small area variation; (3) Park and colleagues' analysis of County Health Rankings and Roadmaps; and (4) the RAND Health Insurance Experiment.

The researchers found that using different data sets, the four methods yielded estimates ranging from 0 to 17 percent of premature mortality attributable to deficiencies in health care access or delivery. For behavioral and social factors, estimates of the effect ranged from 16 to 65 percent.

"The recently enacted Chronic Care Act allowing Medicare Advantage plans to cover interventions beyond traditionally defined health care is a step in the right direction," the authors write. "Due to a longer duration of health benefit, extending similar coverage policies to pregnant women and children enrolled in Medicaid may generate even higher yields."

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