TY - JOUR AU - Cutler,David M. AU - Landrum,Mary Beth AU - Stewart,Kate A. TI - Intensive Medical Care and Cardiovascular Disease Disability Reductions JF - National Bureau of Economic Research Working Paper Series VL - No. 12184 PY - 2006 Y2 - May 2006 UR - http://www.nber.org/papers/w12184 L1 - http://www.nber.org/papers/w12184.pdf N1 - Author contact info: David M. Cutler Department of Economics Harvard University 1875 Cambridge Street Cambridge, MA 02138 Tel: 617/496-5216 Fax: 617/496-8951 E-Mail: dcutler@harvard.edu Mary Beth Landrum Harvard Medical School Department of Health Care Policy 180 Longwood Avenue Boston, MA 02115-5899 Tel: (617) 432-2460 Fax: (617) 432-2563 E-Mail: landrum@hcp.med.harvard.edu Kate Stewart Department of Health Care Policy 180 Longwood Ave Boston, MA 02115 Tel: 617-432-3497 Fax: 617-432-2463 E-Mail: kstewart@mathematica-mpr.com M1 - published as David M. Cutler, Mary Beth Landrum, Kate A. Stewart. "Intensive Medical Care and Cardiovascular Disease Disability Reductions," in David M. Cutler and David A. Wise, editors, "Health at Older Ages: The Causes and Consequences of Declining Disability among the Elderly" University of Chicago Press (2008) M2 - featured in NBER digest on 2006-05-01 AB - There is little empirical evidence to explain why disability declined among the elderly over the past 20 years. In this paper, we explore the role of improved medical care for cardiovascular disease on health status improvements over time. We show that the incidence of cardiovascular disease hospitalizations remained relatively constant between 1984 and 1999 at the same time that post-event survival improved and disability declined. We find that use of appropriate therapies, including pharmaceuticals such as beta-blockers, aspirin, and ace-inhibitors, and invasive procedures, explains up to 50% and 70% of the reductions in disability and death over time, respectively. Elderly patients living in regions with high use of appropriate medical therapies had better health outcomes than patients living in low-use areas. Finally, we estimate that preventing disability after an acute event can add as much as 3.7 years of quality-adjusted life expectancy, or $316,000 of value. ER -