title: Beyond health promotion: reducing need and demand for medical care.
abstract: A population's medical need represents its illness burden. Medical demand represents the service level requested for a particular need. Medical care costs are, in large part, a function of need and demand. Our review of health education programs designed to reduce health risks and reduce costs identified thirty-two programs with documented effectiveness, generally achieving claims reductions of 20 percent. Specific program features including chronic disease self-management, risk reduction, and increased self-efficacy appear important. A broadened definition of health promotion focused on increased personal responsibility for health-related actions and directed at improvement of long-term health outcomes also could reduce health care costs.
authors.affiliation: Stanford University, Palo Alto, CA, USA.
authors.forename: J F
authors.initials: JF
authors.lastname: Fries
authors.forename: C E
authors.initials: CE
authors.lastname: Koop
authors.forename: J
authors.initials: J
authors.lastname: Sokolov
authors.forename: C E
authors.initials: CE
authors.lastname: Beadle
authors.forename: D
authors.initials: D
authors.lastname: Wright
mesh_terms: D017281:Cost of Illness; D019033:Delivery of Health Care, Integrated; D019468:Disease Management; D006265:Health Care Coalitions; D018166:Health Care Reform; D019538:Health Care Surveys; D006266:Health Education / Q000458:organization & administration*; D006291:Health Policy; D006293:Health Promotion / Q000458:organization & administration*; D006301:Health Services Needs and Demand / Q000191:economics*; D006801:Humans; D017146:Models, Organizational; D012648:Self Care; D014481:United States