Leegail Adonis

Leegail Adonis

University of Witwatersrand, South Africa

Title: Health-Care Cost Outcomes And Adherence To Screening Guidelines In A Health-Insured Population


Leegail Adonis is a Public Health Physician with a PhD in Public Health from the University of Witwatersrand. She has a particular interest in preventative medicine and has worked for one of the largest health insurers in South Africa as well as on various projects in collaboration with the World Health Organization. She currently works as a Medical Specialist for the National Department of Health, Non-communicable diseases Directorate in South Africa.


Being up to date with screening guidelines should infer a cost benefit for medical insurance organizations. This study assessed whether there were any difference in health care expenses between those up to date with screening guidelines and those not. A retrospective longitudinal cohort study for the period 2006-2011 was conducted consisting of 170,471 health-insured members form a single insurer. Adherence to screening guidelines was found to range from 0.33% for females 41-50 years to 2.21% for females 16-35 years. Only 0.97% of males aged 41-50 years were up to date with screening tests while 2.95% of males 18-40 years were up to date. Both men and women who adhered to screening guidelines had significantly higher health care expenses compared to those not up to date with screening tests. Females 41-50 years who were up to date with screening tests used 362% more out patient expenses than females who were not up to date (median yearly cost of ZAR10 130.09 vs. ZAR2801.52; p<0.001). However, men 18-40 years who were up to date with screening had a median of zero ZAR out patient expenses compared to ZAR3572.60 for men not up to date with screening tests (p=0.002). In conclusion, health care expenditure were significantly higher in both males and females up to date with screening guidelines except for men aged 18-40 years who had significantly lower out patient expenses. Greater emphasis should be placed on males to screen regularly as they tend to consume less out of hospital health care resources.

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