BEYOND HEALTH PROMOTION - REDUCING NEED AND DEMAND FOR MEDICAL-CARE

A population's medical need represents its illness burden. Medical dem and represents the service level requested for a particular need. Medi cal care costs are, in large part, a function of need and demand. Our review of health education programs designed to reduce health risks an d reduce costs identified thirty-two programs with documented effectiv eness, generally achieving claims reductions of 20 percent. Specific p rogram features including chronic disease self-management, risk reduct ion, and increased self-efficacy appear important. A broadened definit ion of health promotion focused on increased personal responsibility f or health-related actions and directed at improvement of long-term hea lth outcomes also could reduce health care costs.