Short-term Savings Research Articles

Behaviorally informed policies for household financial decisionmaking

Low incomes, limited financial literacy, fraud, and deception are just a few of the many intractable economic and social factors that contribute to the financial difficulties that households face today. Addressing these issues directly is difficult and costly. But poor financial outcomes also result from systematic psychological tendencies, including imperfect optimization, biased judgments and preferences, and susceptibility to influence by the actions and opinions of others. Some of these psychological tendencies and the problems they cause may be countered by policies and interventions that are both low cost and scalable. We detail the ways that these behavioral factors contribute to consumers' financial mistakes and suggest a set of interventions that the federal government, in its dual roles as regulator and employer, could feasibly test or implement to improve household financial outcomes in a variety of domains: retirement, short-term savings, debt management, the take-up of government benefits, and tax optimization.

Combined endoscopic and laparoscopic surgery (CELS)

Patients who present with benign but difficult colon polyps that are not amenable for endoscopic removals will typically undergo colon resection. Although the laparoscopic approach has improved short-term outcomes, morbidities associated with bowel resection are still significant. A combined approach using both laparoscopy and colonoscopy [combined endoscopic laparoscopic surgery (CELS)] is a safe and effective alternative to bowel resection and may result in significantly improved short-term outcomes and cost savings over colon resection.

Impulsywne oszczędności osób młodych – wyniki badania eksperymentalnego

The article presents analysis of priming effect on distribution of income among impulsive consumption, short-term savings and long-term pension savings declared by young adults. Students of economics and management (N=212; 152 women; mean age=21.33 M [0.931]) were asked to split hypothetical income of PLN 1.000 among the four objectives, retirement savings among them. An excerpt from newspaper article noting that pensions in Poland in 2060 were expected to be very low, had been presented to experimental group (N=96) prior to decision task. Differences in distribution of amounts between experimental and control group were analysed. Current expenses for participants’ pleasure as well as their close ones were cut in the experimental group and average amount declared as pension savings increased from PLN 80.69 (control group) to PLN 211.10. However, savings to current bank account remained unchanged. Age, gender, employment experience and the way participants received income (either earned or won/found) did not moderate distributions. Logistic regression analysis revealed that 2.4-fold increase of likelihood of saving amount declarations above the average (PLN 139.75) was caused by appearance of persuasive information only. Circumstances of decision-making suggested that in the analysed case, priming effect led to impulsive rather than rational saving.

A cadeia de valor em saúde: tornar os sistemas de saúde mais sustentáveis

In the current economic crisis, health systems in Portugal and elsewhere in Europe have attempted to increase efficiency in the delivery of health services. However, current approaches to evaluate costs constitute a barrier for creation of value. They lead to cost control measures, which might be ineffective. Cost control without assessment of health outcomes is counterproductive. Although it might result in potential short-term savings, it may limit effectiveness and compromise long-term sustainability. There is evidence that investment in primary health care and disease prevention can reduce the increasing pressure on emergency services, which are more expensive. Attention to health outcomes in relation to costs should define the structure for improvements in the health care system. Focusing on the value of health can release the existing potential for innovation in Portuguese society. A more innovative society will be healthier, more productive, and more resilient to future financial crises.

Budget impact of secondary hyperparathyroidism treatment in chronic kidney disease in an Ecuadorian social security hospital.

BackgroundChronic kidney disease (CKD) is a disorder with high morbidity and mortality worldwide whose complications generate multiple costs. In Ecuador, only a few healthcare institutions have implemented management protocols aimed to reduce costs and to improve the quality of life of patients. The aim of this study is to evaluate the short-term (1-year) and long-term (5-year) costs and savings in the management of secondary hyperparathyroidism (SHPT) of hemodialyzed CKD patients by comparing calcitriol and paricalcitol in a large social security hospital in Quito, Ecuador.MethodsThe estimation model assessed the resources used in the management of SHPT by comparing prospectively the cost savings within 1-year and 5-year time horizon with calcitriol and paricalcitol. Hospitalization, erythropoietin (EPO), treatment doses, intravenous iron consumption, and medical supplies were estimated according international references, based on the initial parathormone level (iPTH) of patients. The Ecuadorian National Reference costs (2014–2015) and institutional costs were used to calculate treatment costs. A statistical sensitivity analysis was also performed.ResultsThe study was based on data from 354 patients of whom 147 (41.4 %) had a value of iPTH in the range 300–600 pg/ml, 45 (12.8 %) in the range 601–800 pg/ml, and 162 (45.7 %) over 800 pg/ml. The 1-year estimated costs per patient for calcitriol and paricalcitol, respectively, were: medication, 63.88 USD and 1,123.44 USD; EPO, 19,522.95 USD and 16,478 USD; intravenous iron 143.21 USD and 187.76 USD. Yearly hospitalization costs per patient were 11,647.99 USD with calcitriol and 8,019.41 USD with paricalcitol. Total yearly costs per patient amounted to 31,378.02 USD with calcitriol and 25,809.50 USD with paricalcitol. Total savings using paricalcitol were 5,568.52 USD per patient compared with calcitriol. The 5-year cumulative medication costs were 319 USD for calcitriol and 2,403 USD for paricalcitol; EPO with calcitriol was 97,615 USD and with paricalcitol 82,394 USD; intravenous iron with calcitriol was 716 USD and paricalcitol 939 USD. Hospitalization costs for patients with calcitriol and paricalcitol were 43,095 USD and 62,595 USD, respectively. Total savings using paricalcitol amounted 32,414 USD per patient compared with calcitriol.ConclusionsParicalcitol use generated more cost savings than calcitriol after 1 and 5 years.

A pilot study of reduction in healthcare costs following the application of intensive short-term dynamic psychotherapy for psychogenic nonepileptic seizures.

The purpose of this study was to examine preliminary evidence of intensive short-term dynamic psychotherapy (ISTDP) as a treatment option for psychogenic nonepileptic seizures (PNES) in terms of impact on healthcare costs, emotional wellbeing, and somatic symptoms. Drawn from a sample of patients treated in a tertiary psychiatric service over a nine-year period, this naturalistic pilot study compared within-group changes from pretreatment with each year up to three years posttreatment, in physician visits, physician costs, hospital admissions, and overall hospital costs. Twenty-eight patients with PNES received ISTDP with average treatment duration of 3.6 sessions. Healthcare costs significantly reduced in follow-up compared with those in baseline, with patient costs falling below the healthy population means, and reductions in healthcare costs compared with those in baseline by 88% in year one, 90% in year two, and 81% in year three. This was accompanied by significant reductions in symptoms and interpersonal problems. These preliminary findings indicate the potential for short-term and long-term healthcare savings and improvements in emotional wellbeing, for patients with PNES from the application of ISTDP. Further research evaluating the impact of ISTDP on seizure reduction and comparing this approach with control conditions is warranted.

Value-based procurement: Canada's healthcare imperative.

Value-based healthcare models are being adopted globally to maximize value for patients. Given that procurement is at the heart of purchasing value, value-based procurement goes hand in hand with value-based healthcare. Shifting procurement's traditional focus on short-term cost savings to a more holistic objective that includes health system performance and patient outcomes, giving preference to longer-term cost efficiencies, and working with suppliers to identify opportunities to develop more innovative products and services, is proving successful in leading jurisdictions. This article presents an overview of value within healthcare systems and how healthcare value-based procurement is being implemented across various jurisdictions.

Trade-offs in lean vs. outsourced supply chains

Lean supply chain management is well established, effective in improving inventory control as well as leading to greater quality. Continuous improvement obtained from lean implementation is expected to lead to better learning, yielding added profitability over time. However, the growth of global supply chains lead to increased complexity and variability, which may not always favour the lean management style. Impact on total cost is often difficult to precisely estimate, in part due to high levels of uncertainty with respect to disaster and catastrophe, changing governmental regulation around the world, and in part due to increased variability from longer supply lines. We examine some of the cost impacts of lean systems vs. outsourcing policies with assumed purchasing cost advantages through simulation of a global supply chain with detailed inventory factors, and compare relative profit impact. These results are used to argue that in some circumstances strategic considerations such as lower purchasing cost can override short-term inventory savings obtained from lean systems.

Effects of phosphoric acid sprayed into an incinerator furnace on the flue gas pressure drop at fabric filters

Fabric filters are widely used to remove dust from flue gas generated by waste incineration. However, a pressure drop occurs at the filters, caused by growth of a dust layer on the filter fabric despite regular cleaning by pulsed-jet air. The pressure drop at the fabric filters leads to energy consumption at induced draft fan to keep the incinerator on negative pressure, so that its proper control is important to operate incineration facility efficiently. The pressure drop at fabric filters decreased whenever phosphoric acid wastewater (PAW) was sprayed into an incinerator for treating industrial waste. Operational data obtained from the incineration facility were analyzed to determine the short- and long-term effects of PAW spraying on the pressure drop. For the short-term effect, it was confirmed that the pressure drop at the fabric filters always decreased to 0.3–1.2kPa within about 5h after spraying PAW. This effect was expected to be obtained by about one third of present PAW spraying amount. However, from the long-term perspective, the pressure drop showed an increase in the periods of PAW spraying compared with periods for which PAW spraying was not performed. The pressure drop increase was particularly noticeable after the initial PAW spraying, regardless of the age and type of fabric filters used. These results suggest that present PAW spraying causes a temporary pressure drop reduction, leading to short-term energy consumption savings; however, it also causes an increase of the pressure drop over the long-term, degrading the overall operating conditions. Thus, appropriate PAW spraying conditions are needed to make effective use of PAW to reduce the pressure drop at fabric filters from a short- and long-term point of view.

Demographic Risks of the Pension Reform in the Russian Federation

The purpose of the study is to analyze the impact of the demographic crisis in the country’s fiscal system. In the article, the pension system for the first time is considered as a multifactorial model, which during the different historical periods corrects the degree of its dependence on the interdependent complex of macroeconomic and demographic factors. The economically sound and socially correct accounting of the interference of retirement age and the specified development factors of pension system requires a fundamental change in the methodological approaches to the problem of raising the retirement age by using the actuarial methods of forecasting. The actuarial analysis of the problem of retirement age shows that the perception of the linear dependence on demographic parameters of the age when the national pension is awarded cannot be considered as a tool for regulating the efficiency of the pension system. For the science-based solution to the problem of rising the retirement age, along with the dynamics of demographic parameters, it is necessary to take into account the whole range of macroeconomic conditions for the state development as well as the long-term socio-economic consequences. Another significant result of the study are the specific parameters of the actuarial assessments of the impact of demographic and macroeconomic conditions of increasing the retirement age in Russia, conducted using the state statistical data. The practical proposals to mitigate the negative economic consequences are formulated. The key conclusion reached is that the raising of the retirement age should be aimed exclusively at the economic stimulation of the formation of the pension rights of the insured in the long term, rather than to the short-term savings of the state budget. The methodological approaches grounded in the work, and the quantitative results of the actuarial calculations may be applied in the shaping the public pension policy when preparing the regulations for raising the retirement age, the pension formula for calculating the pension rights of the insured, the mechanism of pension indexation.

Cost Analysis of Motivational Interviewing and Preschool Education for Secondhand Smoke Exposures.

This study determines if expenditures associated with implementing a combined motivational interviewing (MI) and Head Start-level education program (MI+Education), as compared to education alone, yield cost savings to society. Post hoc cost analyses were applied to a randomized controlled-trial of MI among predominantly African American, low-income caregivers of 330 Baltimore City Head Start students who reside with a smoker. The primary outcome was the cost savings of MI+Education from averted direct secondhand smoke exposure (SHSe)-related acute healthcare events and inferred indirect costs (work days lost, transportation and reduction in cigarettes smoked). The net direction of savings was defined by the sum of averted direct and indirect costs of the MI+Education intervention at 3, 6 and 12 months, benchmarked against the Education alone cohort at the equivalent time periods. The costs saved by the MI+Education intervention, relative to Education alone, resulted in savings at solely the 12-month follow-up time point. Significant savings were appreciated from averted emergency department (ED) visits at 12 months ($4410; 95% simulation interval [SI]: $2241, $6626) for the MI+Education group. The total savings at 12 months ($2274; 95% SI: -3916, $8442) could not overcome additional program costs of implementing MI to Head Start-level education ($13 695; 95% SI: $11 250, $16 034). This study is the first to examine the cost of either intervention on SHSe-attributed pediatric healthcare costs from a population level relevant for federal and community decision makers. Intervention costs could not be offset by short-term savings but a trend towards positive savings was appreciated 1 year after implementation. Behavioral interventions are effective in reducing SHSe in children. However, many of these interventions are not implemented in community settings due to lack of resources and money. Behavioral strategies may be a cost-saving addition to the national initiatives to create smoke-free home environments. The long-term benefits of MI, as evidenced from cost savings from averted ED visits, appeared to show MI+Education to be a robust long-term strategy. The decrease of acute healthcare services at 12 months may be informative for policy decision makers seeking to allocate limited resources to reduce the usage of costly ED services and hospital readmissions.

Measuring, monitoring, and managing the green practices in mid-sized restaurants in China

ABSTRACTThis study explored the economic feasibility of adopting green practices in medium-sized restaurants in China. In particular, the short-term and long-term savings and environmental impact of adopting changes that do not require large investment were examined. Concepts from waste hierarchy and lean manufacturing served as the basis. Two mid-sized restaurants that were similar in terms of sales revenue, number of customers served, and payroll were selected. A number of incremental interventions were implemented and tested to identify the costs and/or benefits of sustainable management. Finally, this study made recommendations to restaurant owners, managers, and stakeholders.

Technology Focus: Production and Facilities (December 2015)

Technology Focus Advances in technologies for production and facilities are being driven by the development of unconventional resources and the need for more-efficient and -reliable operations. Considerable progress is being made, for example, on the design and performance of wellbore-inflow-control devices. The objective of this technology is to control both the volume and the character of fluids entering an extended-length wellbore. Both passive and autonomous devices are now available from a number of suppliers. Field experience with this technology was the subject of 10% of the papers in this year’s survey of publications and presentations. Pipeline technology continues its rapid evolution with a focus on the safe operation of, and the early detection of breaks and leaks in, long-distance lines. The environmental hazards associated with unplanned fluid losses from material failures or unwelcome human intervention make the deployment of acoustic monitoring technologies increasingly desirable and economically viable. In some geographical areas, strong environmental and safety concerns about pipelines will most likely favor the installation of such technologies on any line passing through urban or other sensitive environments. With low oil and gas prices being a continuing drag on our industry, a significant amount of work was reported on field-optimization and operations-improvement (i.e., cost-reduction) technology. Authors worldwide described their efforts to reduce unplanned shutdowns, lower maintenance costs, improve operational reliability, and squeeze more barrels out of existing wells by developing field-optimization models. One interesting development associated with production optimization is the use of nanotechnologies to address issues ranging from the control of rock wettability characteristics to the development of fluids with improved heat-transfer characteristics. These applications are moving the field of nanomaterials from the character of “science projects” to emerging or commercial technologies. Finally, the trend toward the increased use of modeling and simulation technologies, which was identified in this feature last year, continues unabated. More than 25% of the papers reviewed for this year’s feature were concerned with the development of models and simulations or were associated with their use and validation. The emphasis was heavy on the generation of models and simulations that were simple to use, were computationally efficient, and that generated short-term realizable cost savings. One interesting paper described the development of a “fuzzynistic” model for more accurate predictions of flow patterns and pressure losses in pipelines, a critical topic for the design and operational control of surface facilities. JPT Recommended additional reading at OnePetro: www.onepetro.org. IPTC 17977 Performance of Autonomous- Inflow-Control Completion in Heavy-Oil Reservoirs by Eltazy Eltaher, Heriot-Watt University, et al. SPE 174812 Fuzzynistic Models for Multiphase-Flow-Pattern Identification by Florentina Popa, Halliburton, et al. SPE 174746 CFD Study for Heat Transfer and Flow Characteristics of Nanofluid in a Flat-Tube Heat Exchanger by Mohamed Elsebay, Gempetco, et al.

PTH-083 Selective monitoring of antitnf drug levels and antibodies will reduce short-term prescribing costs and provide early personalised tailoring of antitnf therapy in routine ibd practice: Abstract PTH-083 Table 1

Introduction Clinical trial results suggest that measurement of antiTNF drug levels (ATL) and antibodies (ATA) may have a cost-saving as well as clinically beneficial effect in patients with IBD. We aimed to assess whether selective monitoring of ATL and ATA reduces prescribing costs and how it affects clinical decisions in ordinary clinical practice. Method ATL and ATA were assayed in 47 (19%) of our 247 antiTNF-treated IBD patients (Crohn’s disease 41, ulcerative colitis 4 and pouchitis 2; (on infliximab 45, on adalimumab 2)) because of either secondary loss of response (n = 11) or a dosage of infliximab (IFX) exceeding 5 mg/kg every 8 weeks (n = 36). ATL and ATA were measured by automated LISA-TRACKER assay (Theradiag, France) at Viapath, St Thomas’ Hospital. For each patient, the outcomes of decisions about therapeutic strategy based on clinical assessment alone were compared against those based on assay results combined with clinical criteria. AntiTNF prescribing and surgery costs were predicted for the ensuing 4 months for the two decision-making strategies, assuming that infliximab phials were shared. Results Outcomes of the decisions taken are summarised in the Table. Prescribing costs estimated for the subsequent 4 months (17 weeks) for clinically based decisions were £225,825 and for assay based strategies were £209,772 (£3525 assay costs included). Predicted total cost savings using the assay based decisions, taking into account referrals for surgery and for trial drugs, were £16,053 in 4 months. Clinically based decisions led to more patients staying on antiTNFs, while assay-based decisions caused more patients to be switched to an alternative antiTNF, recruited to trials and referred for surgery. In 19/47 patients, both decision-making approaches gave the same outcome. Conclusion Measurement of antiTNF drug levels and antibodies in selected patients should produce short-term cost savings in ordinary clinical practice. Longer follow-up is needed to assess the clinical impact of the decisions made using these assays in combination with clinical criteria, but is likely to amplify the savings they make possible. Disclosure of interest None Declared.

Decision-making criteria in tactical make-or-buy issues: an empirical analysis

Purpose – The purpose of this paper is to seek to contribute to the assessment of the impact of a number of decision-making criteria in resolving tactical make-or-buy issues in enterprises operating in Greece. Moreover, it sheds light on the relationship between the impact of each criterion and a number of independent variables. Design/methodology/approach – Initially, depth interviews were made with purchasing managers in ten industrial firms operating in Greece. The findings of these interviews and the review of the pertinent literature provided the basis for the questionnaire design. Then, a copy of the questionnaire and a prepaid self-addressed return envelope were mailed to a stratified sample of 300 industrial firms operating in Greece. By the end of this process, 85 questionnaires were received, representing a 28.3 percent response rate. Findings – Cost and quality appear to be the criteria with the most impact, which indicates that companies usually resolve tactical make-or-buy issues in order to achieve short-term cost savings or operational advantage. The emphasis placed upon the other criteria tends to vary with the situation under which the particular make-or-buy issue is resolved. Originality/value – It develops a more precise assessment of the impact of each make-or-buy decision-making criterion and investigates the relationship between this impact and a number of independent variables.

The application of outsourcing decision-making methods in a logistics context in South Africa

Background: Companies have often relinquished the control of important business functions to outside suppliers for the sake of short-term savings and because of the lack of use of proper decision-making methods within the business.Objectives: This article identified three methods of decision-making and applied it to a logistics outsourcing problem. The logistics outsourcing problem consisted of a make-or-buy decision as well as a supplier selection process. The purpose of the study was to determine the most suitable method in the case of logistics outsourcing.Method: The decision-making methods were applied to a South African case study within the fast moving consumer goods (FMCG) industry. The logistics functions considered in the case study included secondary distribution and warehousing of finished goods. Each method considered the same evaluation criteria and the results were analysed and compared.Results: Each method produced different results to the logistics outsourcing problem. The method developed by Platts, Probert and Canez (2000) suggested that the logistics functions be insourced. The decision tree method suggested outsourcing both functions, with a unit rate cost model. The results from the linear programming (LP) method indicated that the secondary distribution function should be insourced and the warehousing function outsourced, with a fixed and variable cost model pending further analysis of the demand trends.Conclusion: The study provides empirical evidence that proven outsourcing decision-making methods, such as the method developed by Platts et al. (2000), the LP method and the decision tree method traditionally applied to a manufacturing outsourcing decision problem, can be adapted and applied to a logistics outsourcing decision problem of a South African FMCG company.

Encouraging Low- and Moderate-Income Tax Filers to Save: Implementation and Interim Impact Findings from the SaveUSA Evaluation

SaveUSA, a voluntary program launched in 2011 in four cities (New York City, Tulsa, San Antonio, and Newark), encourages low- and moderate-income individuals to set aside money from their tax refund for savings. Tax filers at participating Volunteer Income Tax Assistance (VITA) sites can directly deposit all or a portion of their tax refund into a special savings account, set up by a bank or credit union, and pledge to save between $200 and $1,000 of their deposit for about a year. Money can be withdrawn from SaveUSA accounts at any time and for any purpose, but only those who maintain their initially pledged savings amount throughout a full year receive a 50 percent match on that amount. Account holders, irrespective of match receipt, can deposit tax refund dollars in subsequent years and become eligible to receive additional savings matches on their new tax refund deposits.This report presents findings on SaveUSA’s implementation in all four cities and its early effects on savings and other financial outcomes in two cities: New York City and Tulsa. In these latter cities, a randomly selected half of the tax filers who were interested in SaveUSA in 2011 could open accounts (the “SaveUSA group”), but the other half could not (the control group). The report compares the savings and other financial behaviors of the two groups over time to estimate SaveUSA’s effects. The findings thus suggest the effects that savings policies structured similarly to SaveUSA might have.SaveUSA’s operation and evaluation are funded through the federal Social Innovation Fund (SIF), a public/private partnership administered by the Corporation for National and Community Service. This particular SIF project is led by the Mayor’s Fund to Advance New York City and the NYC Center for Economic Opportunity (CEO) in collaboration with MDRC. Matching funds required by the SIF were provided by several foundations and organizations. CEO, with the New York City Department of Consumer Affairs Office of Financial Empowerment (OFE), which conceived and launched an early version of the model, leads SaveUSA operations; MDRC is conducting the program’s evaluation.Key Findings: SaveUSA was implemented successfully in all four cities. During the first program year, individuals in the SaveUSA group directly deposited an average of $506 of their tax refunds into SaveUSA accounts.About two-thirds of those in the SaveUSA group saved for about a year and received a first savings match, which averaged $291 among those who received it. About two-fifths of the SaveUSA group pledged to save part of their tax refund again in the program’s second year.At the 18-month follow-up point, SaveUSA had increased the percentage of individuals with any short-term savings (by 7 percentage points) and increased the total amount of savings individuals held on average (by $512), compared with what they would have saved without the program. The program also had increased the proportion of those who expressed a continued commitment to save.No effects were found on individuals’ amount of debt, material hardship, or other aspects of financial security over the 18-month follow-up period.A subsequent report in late 2015 will examine SaveUSA’s effects over 36 to 42 months and will present a much more complete assessment of whether SaveUSA can sustain savings and improve individuals’ overall financial well-being.

A more generalizable method to evaluate changes in health care costs with changes in health risks among employers of all sizes.

The objective of this study was to estimate the association between changes in health care expenditures relative to changes in health risk status for employers of all sizes. Repeat health risk assessments (HRAs) were obtained from 50,005 employees and spouses with 2 years of health plan enrollment, and from 37,559 employees and spouses with 3 years of enrollment in employer-sponsored medical coverage. Changes in health care expenditures were measured from the year before completion of the first HRA to the years before and after the completion of the second HRA. Propensity score weighting was used to adjust for those who did not repeat the HRA so results could be extrapolated to the larger population. Propensity score weighted multiple regression analyses were used to estimate the relationship between changes in health care expenditures with changes in risk status for 9 risk categories. Significantly higher health care expenditures were associated with those who moved from low risk to medium or high risk, compared to those who remained low risk. Expenditure reductions estimated for those who improved their health status from high risk to medium or low risk were not statistically significant. This study is unique because of its large sample size, its use of data from a wide range of employer sizes, and its efforts to extend generalizability to those who did not complete both HRAs. These results demonstrate that the potential for short-term health care savings may be greater for programs that help maintain low risk than for programs focused on risk reduction.

No short-term savings in health care expenditures for physically active adults

ObjectiveThe purpose of this study was to investigate the association of physical activity and health care expenditures in a nationally representative sample of non-disabled adults. MethodsThis was a secondary analysis of data from 8843 adults. Physical activity measures were derived from participants in the 2006 and 2007 National Health Interview Survey. Demographic and expenditure variables came from the Medical Expenditure Panel Survey data files for panels 12 (2007–2008) and 13 (2008–2009). Multivariable regression models were used to determine the association between levels of physical activity participation and total health care expenditures, drug expenditures, and out-of-pocket health care expenditures. ResultsUnadjusted data revealed lower health care expenditures among those whose activity level met the CDC guidelines with greater savings apparent among those who exercised above recommended guidelines. However, in the models that adjusted for age, sex, race, income and health status these differences disappeared. ConclusionIn the short-term, the amount of physical activity undertaken by an adult may have little effect on the expenditures for health services, drugs and the money expended directly out-of-pocket. However, given the benefits of physical activity in terms of chronic disease prevention there are very likely long-term expenditure savings to be had.

The Effect of Chairside Chronic Disease Screenings by Oral Health Professionals on Health Care Costs

We estimated short-term health care cost savings that would result from oral health professionals performing chronic disease screenings. We used population data, estimates of chronic disease prevalence, and rates of medication adherence from the literature to estimate cost savings that would result from screening individuals aged 40 years and older who have seen a dentist but not a physician in the last 12 months. We estimated 1-year savings if patients identified during screening in a dental setting were referred to a physician, completed their referral, and started pharmacological treatment. We estimated that medical screenings for diabetes, hypertension, and hypercholesterolemia in dental offices could save the health care system from $42.4 million ($13.51 per person screened) to $102.6 million ($32.72 per person screened) over 1 year, dependent on the rate of referral completion from the dental clinic to the physician's office. Oral health professionals can potentially play a bigger role in detecting chronic disease in the US population. Additional prevention and monitoring activities over the long term could achieve even greater savings and health benefits.