Estimating the Costs of Medicalization
Department of Sociology, MS-71, Brandeis University, Waltham, MA 02454, United States. Social Science [?] Medicine
(Impact Factor: 2.89).
03/2010; 70(12):1943-7. DOI: 10.1016/j.socscimed.2010.02.019
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.
Available from: Soo Downe
- "The focus on adverse events to the exclusion of measures of health and wellbeing is occurring in parallel with an increasing tendency to classify some normal life events as potential sources of ill-health . This is part of a process in which the term 'medicalisation' is increasingly used pejoratively to denote the overuse of routine technical and pharmacological interventions without scientific evidence of their benefits . In some cases, these interventions increase the occurrence of unwanted outcomes. "
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Health care outcomes used in service evaluation and research tend to measure morbidity and mortality. This is the case even in maternity care, where most women and babies are healthy. Salutogenesis theory recognises that health is a continuum, with explicit inclusion of wellbeing as well as illness and pathology. This offers the potential to reframe the outcomes and therefore, the focus of, maternity care research and provision.
The aim of this study was to identify how salutogenesis has been defined and used in maternity care research undertaken with healthy women.
A scoping review was undertaken, using a formal pre-defined search strategy. Inclusion criteria encompassed research papers relating to the maternity episode up to one year after birth, using salutogenesis or any of its associated concepts, focused on healthy women, and written in a language which any of the members of the group could understand. The search was undertaken in two phases (Database inception-April 2011 and May 2011 -February 2013). Included studies were subject to narrative analysis.
Eight papers met the inclusion criteria. They covered seven topics, spanning the antenatal, intrapartum and postnatal periods. Only two papers employed both positive health orientation and explicit use of Antonovsky's theory. The remaining studies used discrete aspects of the theory.
Salutogenic framing is rarely used in maternity care research with healthy participants. An increase in research that measures salutogenically orientated outcomes could, eventually, provide a balance to the current over-emphasis on pathology in maternity care design and provision worldwide.
Available from: hsb.sagepub.com
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ABSTRACT: The social construction of illness is a major research perspective in medical sociology. This article traces the roots of this perspective and presents three overarching constructionist findings. First, some illnesses are particularly embedded with cultural meaning--which is not directly derived from the nature of the condition--that shapes how society responds to those afflicted and influences the experience of that illness. Second, all illnesses are socially constructed at the experiential level, based on how individuals come to understand and live with their illness. Third, medical knowledge about illness and disease is not necessarily given by nature but is constructed and developed by claims-makers and interested parties. We address central policy implications of each of these findings and discuss fruitful directions for policy-relevant research in a social constructionist tradition. Social constructionism provides an important counterpoint to medicine's largely deterministic approaches to disease and illness, and it can help us broaden policy deliberations and decisions.
Available from: virtualmentor.ama-assn.org
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