The Effectiveness of Health Screening

Health Econ. 2015 Aug;24(8):913-35. doi: 10.1002/hec.3072. Epub 2014 Jul 18.

Abstract

Using a matched insurant-general practitioner panel data set, we estimate the effect of a general health-screening program on individuals' health status and health-care cost. To account for selection into treatment, we use regional variation in the intensity of exposure to supply-determined screening recommendations as an instrumental variable. We find that screening participation increases inpatient and outpatient health-care costs up to 2 years after treatment substantially. In the medium run, we find cost savings in the outpatient sector, whereas in the long run, no statistically significant effects of screening on either health-care cost component can be discerned. In sum, screening participation increases health-care cost. Given that we do not find any statistically significant effect of screening participation on insurants' health status (at any point in time), we do not recommend a general health-screening program. However, given that we find some evidence for cost-saving potential for the sub-sample of younger insurants, we suggest more targeted screening programs.

Keywords: health screening; health-care cost; mortality; sick leave.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cost-Benefit Analysis
  • Female
  • Health Expenditures / statistics & numerical data*
  • Health Status*
  • Humans
  • Inpatients
  • Insurance Claim Review / statistics & numerical data
  • Male
  • Mass Screening / economics*
  • Middle Aged
  • Models, Econometric
  • Outpatients
  • State Medicine