Table 3

QALYs Saved if Utilization Rates Increase Above Current Levels

Services (Short Name)aSourceCurrently 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 youthdJamal2320530,000
 Tobacco use screening and brief cessation intervention, adultsNCQA24
 Alcohol misuse screening, brief interventionMcKnight-Eily2710140,000
 Colorectal cancer screeningCDC2865110,000
 Influenza immunization, adultsCDC2945100,000
 HPV immunizationdReagan-Steiner305059,000
 Breast cancer screeningNCHS31
 Chlamydia and gonorrhea screeningdCDC324039,000
 HIV screeningChandra332032,000
 Aspirin chemoprevention for those at higher risk of CVDWilliams345030,000
 Cervical cancer screeningNCHS31
 Vision screening, childrenKemper35755,000
 Pneumococcal immunization, adultsCDC28704,000
Services with utilization data assigned at 50%
 Obesity screening, adultseAssigned50540,000
 Healthy diet counseling for those at higher risk of CVDeAssigned50300,000
 Obesity screening, children and adolescentsd,eAssigned5078,000
 Depression screening, adultseAssigned
 AAA screeningeAssigned
 Depression screening, adolescentsd,eAssigned5011,000
 Syphilis screeningeAssigned502,000
  • 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.