Preventive Care and Diagnostic Care describe two types of health care you may receive. Both are ways your health care providers help you stay as healthy as possible. Understanding the difference between the two isn’t always easy, but it’s very important. The goal of preventive care is to detect health problems before symptoms develop, while diagnostic care is given to diagnose or treat symptoms you already have. Preventive care helps detect or prevent serious diseases and medical problems before they can become major. The goal of preventive medicine is to promote health and well-being and prevent disease, disability, and death. Annual check-ups, screenings, dental checkups, immunizations, flu shots, and vaccinations are a few examples of preventive care. This may also be called routine care. Routine health care can prevent the occurrence of illnesses, disease, or other health problems. Because there are so many conditions that often show no warning signs, preventive health screenings can be very effective at providing insights about early disease risk so you can take proactive steps with your doctor to prevent chronic illnesses. It is recommended that adults and children aim to visit their doctor for regular check-ups, even if they feel healthy, to perform disease screening, identify risk factors for disease, discuss tips for a healthy and balanced lifestyle, stay up to date with immunizations and boosters, and maintain a good relationship with a healthcare provider. The right preventive care at the right time can help you stay well and could even save your life.
Preventive healthcare is especially important given the worldwide rise in prevalence of chronic diseases and deaths from these diseases. There are many methods for prevention of disease. Some common disease screenings include checking for hypertension (high blood pressure), hyperglycemia (high blood sugar, a risk factor for diabetes), hypercholesterolemia (high blood cholesterol), screening for colon cancer, depression, HIV and other common types of sexually transmitted disease such as chlamydia, syphilis, and gonorrhea, mammography (to screen for breast cancer), colorectal cancer screening, a Pap test (to check for cervical cancer), and screening for osteoporosis(thinning of the bones). Genetic testing can also be performed to screen for mutations that cause genetic disorders or predisposition to certain diseases such as breast or ovarian cancer. Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices, and are dynamic processes which begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention. These levels might be better described as “prevention, treatment, and rehabilitation”. Listed below are the levels of prevention and the definition.
- Primal and primordial prevention: Primal prevention has been propounded as a separate category of health promotion based on the evidence that epigenetic processes start at conception. Primordial prevention refers to measures designed to avoid the development of risk factors in the first place, early in life with lifestyle only.
- Primary prevention: Methods to avoid occurrence of disease either through eliminating disease agents or increasing resistance to disease. Examples include immunization against disease, maintaining a healthy diet and exercise regimen, and avoiding smoking.
- Secondary prevention: Methods to detect and address an existing disease prior to the appearance of symptoms. Examples include treatment of hypertension (a risk factor for many cardiovascular diseases), and cancer screenings.
- Tertiary prevention: Methods to reduce the harm of symptomatic disease, such as disability or death, through rehabilitation and treatment. Examples include surgical procedures that halt the spread or progression of disease.
Preventive care is frequently received during a routine physical. Diagnostic care may result if a preventive screening detects abnormal results. Diagnostic medical care involves treating or diagnosing a problem you’re having by monitoring existing problems, checking out new symptoms or following up on abnormal test results. Diagnostic tools include radiology, ultrasound, nuclear medicine, laboratory, pathology services, and other tests. Examples of diagnostic medical care include:
- Colon cancer screening (colonoscopy) to evaluate rectal bleeding
- Mammogram to follow up on a breast lump
For example, a Gastroenterologist may ask for a follow-up colonoscopy for a patient. This follow-up is to check for something that may have been detected during the preventive or routine colonoscopy. The follow-up colonoscopy is diagnostic, and not covered as preventive care. Diagnostic tests are either invasive or non-invasive. Invasive diagnostic testing involves puncturing the skin or entering the body. Examples are taking a blood sample, biopsies, and colonoscopies. Non-invasive diagnostic testing does not involve making a break in the skin. Examples include x-rays, a standard eye exam, CT scan, MRI, ECG, and Holter monitoring.
The diagnosis is an important tool for you and your doctor. Doctors and therapists use a diagnosis to advise you on treatment options and future health risks. Another reason a diagnosis matters is that it tells health insurance companies that you have a condition requiring medical care. It’s important to understand the difference between the two types of care because during the same health care visit, you may receive preventive and diagnostic services. While preventive care is provided at no cost for most members, you may be charged for the diagnostic services. Your insurance coverage may be different depending on which type of services you receive. Many preventive services are covered at 100 percent with no out-of-pocket cost to you. Always ask your doctor why a test or service is ordered. The same test or service can be preventive, diagnostic, or routine chronic care (regular care based on a chronic health condition) depending on why it’s done, and the cost for the service may change based on how it’s defined. If a service is considered diagnostic or routine chronic care, your usual copayment, coinsurance, and deductibles apply. It’s important to know what type of service you’re getting. If a diagnostic or routine chronic service is performed during the same healthcare visit as a preventive service, you may have copayment and coinsurance charges. Make sure to refer to your benefit plan for detailed information on your coverage.
