The Value Proposition of Prevention: The Impacts of Pure North S’Energy Foundation’s Preventive Care Program on Acute Care Utilization in Alberta
Bibliographic record
Abstract
This analysis of Pure North S’Energy Foundation’s preventive health services shows that the acute health care cost savings of being pro-active, rather than reactive, and averting chronic disease, are significant, immediate and worth pursuing further. Chronic disease, such as cardiovascular maladies, diabetes, cancer and other long-term illnesses, represents the leading cause of disability and death in Canada. An estimated 25 per cent of expenditures in the public health system go towards treating these frequently avoidable diseases. This health-care cost curve, which sees more money expended on fighting the increase of chronic disease, can be bent, so to speak, through prevention services that offer long-term benefits to people’s health. Preventing disease is not just good for individuals, but for the health system in general, as prevention frees up acute care beds for more timely access by those who need them. The concern for health care decision makers struggling to find dollars to meet current health care needs is that investment in prevention is risky compared spending on medical treatment. It is often expressed that the health cost savings of prevention are too far off in the future and there is a lack of convincing evidence that preventive services and interventions will achieve the health gains expected. Pure North offers participants in its eight-year-old program access to a variety of healthcare practitioners, including doctors, naturopaths, nurses, nurse practitioners and dentists. Participants receive lifestyle counselling and dietary supplements aimed at combating vitamin D insufficiency, obesity, insulin resistance and other problems that can lead to chronic disease. Our study found that participants who stay with the program for two years demonstrate significant reductions in their number of visits to emergency rooms and hospitals. Indeed, after just one year in the program, the number of hospital visits was down 27 per cent and the number of visits for ambulatory care reduced by 14 per cent over a control group matched for age, sex and postal code, who did not participate in the Pure North program. In the second year after joining the program, hospital admissions dropped by 32 per cent for participants aged 55 and over. If these effects could be achieved in the population of Albertans aged 55 to 75, the hospital bed nights freed up per year would be equivalent to adding the acute care bed capacity of the Foothills Medical Centre in Calgary. These figures translate into significant cost differences. The average cost of hospitals, ambulatory care and visits to general practitioners in the year prior to joining Pure North’s program came to $1,320 per individual. Cost reductions in annual health-care utilization among participants ranged from $294 (22 per cent) per person who joined the program to $600 (45 per cent) per person who stayed in the program for at least a year. Two years into the program, a participant could expect to avoid $276 in hospitalization and emergency room costs. The Pure North program is a cost-effective model for preventive health services, resulting in better health and labour productivity for individuals, and considerable savings in public money for the health-care system. Every dollar spent on a participant who stays with the program for at least a year represents a $2.36 benefit in the avoidance of hospitalization and ambulatory care, as well as gains in personal health and productivity. The public health-care system must shift its focus to preventive care if it wants to realize cost savings, efficiency and improved health for Albertans, rather than waiting to treat people until after they become ill with chronic diseases. Pure North offers an important model to help the public system understand how to make that transition to a prevention-oriented mindset.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".