Estimating the costs of medicalization
ABSTRACT Medicalization is the process by which non-medical problems become defined and treated as medical problems, usually as illnesses or disorders. There has been growing concern with the possibility that medicalization is driving increased health care costs. In this paper we estimate the medical spending in the U.S. of identified medicalized conditions at approximately $77 billion in 2005, 3.9% of total domestic expenditures on health care. This estimate is based on the direct costs associated with twelve medicalized conditions. Although due to data limitations this estimate does not include all medicalized conditions, it can inform future debates about health care spending and medicalization.
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Article: Midwifery and Quality CareObstetrical and Gynecological Survey 01/2015; 70(1):15-17. DOI:10.1097/01.ogx.0000460706.27837.c4 · 2.36 Impact Factor
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ABSTRACT: The current definition and management of medical conditions causing impairment and unnecessary disability in workers’ compensation (WC) systems are suboptimal. Fundamental problems include the failure to recognize and address the unique biopsychosocial diathesis of each individual; the powerful influence of human psychology in the genesis, perpetuation, and refractoriness to treatment of many conditions, including medically unexplained symptoms and chronic pain; the work relevance of even non-work-related conditions; the considerable effects of administrative and clinical iatrogenicity; and the plethora of complex factors potentially affecting the course of conditions treated in WC systems. Once claims are established in WC, administrative and medical management of both identifiable pathologic conditions and unexplained symptoms are fragmented, not based on available scientific evidence, and adherent to a biomedical care approach which is not appropriate for a significant number of cases. These obstacles prevent effective understanding and management of many WC cases and may contribute to eventual recovery failure and unnecessary work disability (UWD). This article explores biopsychosocial factors in WC claimants and elements that may contribute to or ameliorate progression to UWD. The author offers a heuristic diathesis stress model of work-related disability as a framework for general and specific interventions to improve system performance and outcomes for all stakeholders.Psychological Injury and Law 09/2013; 6(3):164-182. DOI:10.1007/s12207-013-9162-y