Purpose:
To estimate the relationship between employees’ health risks and health-care costs to inform health promotion program design.
Design:
An observational study of person-level health-care ...claims and health risk assessment (HRA) data that used regression models to estimate the relationship between 10 modifiable risk factors and subsequent year 1 health-care costs.
Setting:
United States.
Participants:
The sample included active, full-time, adult employees continuously enrolled in employer-sponsored health insurance plans contributing to IBM MarketScan Research Databases who completed an HRA. Study criteria were met by 135 219 employees from 11 employers.
Measures:
Ten modifiable risk factors and individual sociodemographic and health characteristics were included in the models as independent variables. Five settings of health-care costs were outcomes in addition to total expenditures.
Analysis:
After building the analytic file, we estimated generalized linear models and conducted postestimation bootstrapping.
Results:
Health-care costs were significantly higher for employees at higher risk for blood glucose, obesity, stress, depression, and physical inactivity (all at P < .0001) than for those at lower risk. Similar cost differentials were found when specific health-care services were examined.
Conclusion:
Employers may achieve cost savings in the short run by implementing comprehensive health promotion programs that focus on decreasing multiple health risks.
Objective:
To test the validity and reliability of the American Heart Association’s (AHA) updated Workplace Health Achievement Index (WHAI).
Methods:
We piloted the updated WHAI with respondent pairs ...at 94 organizations, and examined the inter-rater reliability (percent agreement) for each item on the survey. To evaluate face and content validity, we conducted preliminary focus groups pre-survey, and follow-up cognitive interviews post-survey administration.
Results:
Respondents found the updated WHAI to be comprehensive and useful in identifying gaps and opportunities for improving their health and wellbeing programs. The mean percent agreement on all items was 73.1%. Only 9% (or 14 items out of 146) had poor inter-rater reliability (below 61 percent agreement), but through follow-up cognitive interviews we determined that most were due to artifacts of the study design or were resolved through minor revisions to the survey question, instructions, and/or adding examples for clarity. Only 1 question was deleted due to lack of relevance.
Conclusion:
The updated WHAI is a valid and reliable tool for employers to assess how well they promote the health and wellbeing of their employees.
Evidence about the total cost of health, absence, short-term disability, and productivity losses was synthesized for 10 health conditions. Cost estimates from a large medical/absence database were ...combined with findings from several published productivity surveys. Ranges of condition prevalence and associated absenteeism and presenteeism (on-the-job-productivity) losses were used to estimate condition-related costs. Based on average impairment and prevalence estimates, the overall economic burden of illness was highest for hypertension ($392 per eligible employee per year), heart disease ($368), depression and other mental illnesses ($348), and arthritis ($327). Presenteeism costs were higher than medical costs in most cases, and represented 18% to 60% of all costs for the 10 conditions. Caution is advised when interpreting any particular source of data, and the need for standardization in future research is noted.
Why Should Businesses Support Public Health? Myburgh, Inge; Goetzel, Ron Z.; Roemer, Enid Chung ...
American journal of health promotion,
09/2021, Letnik:
35, Številka:
7
Journal Article
Recenzirano
Odprti dostop
The COVID-19 pandemic presents a unique opportunity to gain support from the business community for rebuilding a more effective and resilient public health infrastructure in the U.S. This commentary ...provides the rationale for more engaged business involvement in efforts to promote public health during the time of COVID-19. Drawing on the current pandemic, the commentary highlights the implications of a fragmented public health system for businesses and the nation at large, the shortcomings of which are apparent as never before.
Chronic disease is the leading cause of death in the United States. Risk factors and work conditions can be addressed through health promotion aimed at improving individual health behaviors; health ...protection, including occupational safety and health interventions; and efforts to support the work-family interface. Responding to the need to address chronic disease at worksites, the National Institutes of Health and the Centers for Disease Control and Prevention convened a workshop to identify research priorities to advance knowledge and implementation of effective strategies to reduce chronic disease risk. Workshop participants outlined a conceptual framework and corresponding research agenda to address chronic disease prevention by integrating health promotion and health protection in the workplace.
Johnson & Johnson Family of Companies introduced its worksite health promotion program in 1979. The program evolved and is still in place after more than thirty years. We evaluated the program's ...effect on employees' health risks and health care costs for the period 2002-08. Measured against similar large companies, Johnson & Johnson experienced average annual growth in total medical spending that was 3.7 percentage points lower. Company employees benefited from meaningful reductions in rates of obesity, high blood pressure, high cholesterol, tobacco use, physical inactivity, and poor nutrition. Average annual per employee savings were $565 in 2009 dollars, producing a return on investment equal to a range of $1.88-$3.92 saved for every dollar spent on the program. Because the vast majority of US adults participate in the workforce, positive effects from similar programs could lead to better health and to savings for the nation as a whole.
A multi-employer database that links medical, prescription drug, absence, and short term disability data at the patient level was analyzed to uncover the most costly physical and mental health ...conditions affecting American businesses. A unique methodology was developed involving the creation of patient episodes of care that incorporated employee productivity measures of absence and disability. Data for 374,799 employees from six large employers were analyzed. Absence and disability losses constituted 29% of the total health and productivity related expenditures for physical health conditions, and 47% for all of the mental health conditions examined. The top-10 most costly physical health conditions were: angina pectoris; essential hypertension; diabetes mellitus; mechanical low back pain; acute myocardial infarction; chronic obstructive pulmonary disease; back disorders not specified as low back; trauma to spine and spinal cord; sinusitis; and diseases of the ear, nose and throat or mastoid process. The most costly mental health disorders were: bipolar disorder, chronic maintenance; depression; depressive episode in bipolar disease; neurotic, personality and non-psychotic disorders; alcoholism;, anxiety disorders; schizophrenia, acute phase; bipolar disorders, severe mania; nonspecific neurotic, personality and non-psychotic disorders; and psychoses. Implications for employers and health plans in examining the health and productivity consequences of common health conditions are discussed.
Health improvements and cost savings are achievable by providing targeted, evidence-based, and cost-effective health promotion and disease prevention programs that reduce modifiable risk factors, ...often the cause of costly chronic diseases. Adopting commonsense health practices does not require expensive technology, medication, specialty training, or elaborate treatment facilities. Instituting environmental, policy, and normative interventions, in addition to individual behavior change programs, can shift our thinking about how we pay for health. Employers' efforts in providing health promotion programs to their workers offer a microcosm of how prevention can lead to populationwide risk reduction and cost savings.
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