QALYs Saved if Utilization Rates Increase Above Current Levels
| Services (Short Name)a | Source | Currently Receiving Services Nationallyb % | Additional QALY Saved if Currently Receiving Services Increased to 90%c |
|---|---|---|---|
| Services with utilization data available | |||
| Tobacco use counseling to prevent initiation by youthd | Jamal23 | 20 | 530,000 |
| Tobacco use screening and brief cessation intervention, adults | NCQA24 Jamal25 King26 | 50 | 460,000 |
| Alcohol misuse screening, brief intervention | McKnight-Eily27 | 10 | 140,000 |
| Colorectal cancer screening | CDC28 | 65 | 110,000 |
| Influenza immunization, adults | CDC29 | 45 | 100,000 |
| HPV immunizationd | Reagan-Steiner30 | 50 | 59,000 |
| Breast cancer screening | NCHS31 CDC28 | 75 | 42,000 |
| Chlamydia and gonorrhea screeningd | CDC32 | 40 | 39,000 |
| HIV screening | Chandra33 | 20 | 32,000 |
| Aspirin chemoprevention for those at higher risk of CVD | Williams34 | 50 | 30,000 |
| Cervical cancer screening | NCHS31 CDC28 | 85 | 14,000 |
| Vision screening, children | Kemper35 | 75 | 5,000 |
| Pneumococcal immunization, adults | CDC28 | 70 | 4,000 |
| Services with utilization data assigned at 50% | |||
| Obesity screening, adultse | Assigned | 50 | 540,000 |
| Healthy diet counseling for those at higher risk of CVDe | Assigned | 50 | 300,000 |
| Obesity screening, children and adolescentsd,e | Assigned | 50 | 78,000 |
| Depression screening, adultse | Assigned Farr36 Edwards37 | 50 | 45,000 |
| AAA screeninge | Assigned Shreibati38 | 50 | 21,000 |
| Depression screening, adolescentsd,e | Assigned | 50 | 11,000 |
| Syphilis screeninge | Assigned | 50 | 2,000 |
AAA = abdominal aortic aneurysm; CDC = Centers for Disease Control and Prevention; CMS = Centers for Medicare & Medicaid Services; CPS = Community Preventive Services; CVD = cardiovascular disease; FDA = Food and Drug Administration; HIV = human immunodeficiency virus; HPV = human papillomavirus; QALY = quality-adjusted life years; USPSTF = US Preventive Services Task Force.
↵a See Table 2 for a description of each service. Childhood immunizations, hypertension screening, and cholesterol omitted from table because of current high utilization rates.
↵b Current utilization rates rounded and reflect approximate average of male and female patients, across all relevant age-groups and other important groups for a service, such as groups at high and low risk for disease.
↵c Indicates additional lifetime QALYs saved if 90% of a cohort of 4 million were offered service as recommended.
↵d Youth services estimated based on a target of 90% of youth receiving service annually, although slightly less than 90% of adolescents aged 12–17 years saw a health care professional in 2012.
↵e Based on limited utilization data. Utilization data were considered limited if existing information was difficult to use to quantify utilization rates and place an upper boundary more precise than 50%. Either utilization data are completely lacking or are available only for a population for which generalizability to US population is highly questionable, or the utilization measures available are poorly aligned with the preventive service as recommended by the USPSTF.