Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkin University, Baltimore, MD 21205, USA.
Int J Health Serv. 2011;41(2):231-8. doi: 10.2190/HS.41.2.c.
The primary hypothesis of this study is that racial/ethnic disparities in health and health care impose costs on numerous aspects of society, both direct health care costs and indirect costs such as loss of productivity. The authors conducted three sets of analysis, assessing: (1) direct medical costs and (2) indirect costs, using data from the Medical Expenditure Panel Survey (2002-2006) to estimate the potential cost savings of eliminating health disparities for racial/ethnic minorities and the productivity loss associated with health inequalities for racial/ethnic minorities, respectively; and (3) costs of premature death, using data from the National Vital Statistics Reports (2003-2006). They estimate that eliminating health disparities for minorities would have reduced direct medical care expenditures by about $230 billion and indirect costs associated with illness and premature death by more than $1 trillion for the years 2003-2006 (in 2008 inflation-adjusted dollars). We should address health disparities because such inequities are inconsistent with the values of our society and addressing them is the right thing to do, but this analysis shows that social justice can also be cost effective.
本研究的主要假设是,健康和医疗保健方面的种族/民族差异给社会的许多方面带来了成本,包括直接的医疗保健成本和间接成本,如生产力损失。作者进行了三组分析,评估了:(1)直接医疗成本和(2)间接成本,分别使用医疗支出调查(2002-2006 年)的数据来估计消除少数民族健康差异的潜在成本节约,以及与少数民族健康不平等相关的生产力损失;以及(3)使用国家生命统计报告(2003-2006 年)的数据来评估过早死亡的成本。他们估计,消除少数民族的健康差异将减少 2003-2006 年(以 2008 年通胀调整后的美元计算)直接医疗保健支出约 2300 亿美元,并减少与疾病和过早死亡相关的间接成本超过 1 万亿美元。我们应该解决健康差异问题,因为这些不平等不符合我们社会的价值观,解决这些问题是正确的做法,但这一分析表明,社会正义也具有成本效益。