This investigation estimates the impact of ten modifiable health risk behaviors and measures and their impact on health care expenditures. Research has shown an established relationship between modifiable health risks such as smoking, inactivity and obesity, and subsequent. The Relationship Between Modifiable Health Risks and Health Care Expenditures: An Analysis of the Multi-Employer HERO Health Risk and Cost Database.
This is particularly true in light of recent reports documenting the efficacy of behavior change intervention strategies, 3 lower health care charges with risk reduction, 4 and a good return on investments in health-related behaviors. Moreover, to our knowledge, no report has adequately controlled in the analysis for chronic conditions, which may confound the relationship of health risks to charges.
In this study we analyze the short-term cost to health plans of modifiable health risks. These data provide an estimate of excess costs incurred by health plans that do nothing to influence modifiable health risks, and may assist health plans in deciding whether strategic investments to modify certain health risks in members is a wise use of scarce resources.
All patients who were aged 40 years or older and enrolled on December 15,were potential subjects for the study. A diagnosis of diabetes mellitus was assigned if the patients had 2 or more ICD-9 codes Heart disease was assigned if the patients had 1 or more ICD-9 codes Hypertension was assigned if the patients had 1 or more ICD-9 codes Dyslipidemia was assigned if the patients had an ICD-9 code of A more detailed description of the identification of patients with specific conditions and the sensitivity, specificity, and positive predictive value of this method has been published.
From 34, patients who had 1 chronic condition, a random sample of patients 7. Hence, the total study population included a stratified random sample of individuals aged 40 years or older. In Augusta mailed survey was administered and subjects who were unable to complete it due to death, disenrollment, or language problems were excluded.Risk Factors of Stroke - Mayo Clinic
In addition, proxy respondents were excluded from all analyses. Data Definitions The question survey instrument included items on demographics, health status, use of preventive services, modifiable health risks, and readiness to change modifiable health risks.
The core of the survey items was adapted from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System, which has reliability coefficients for behavioral risk factors above 0. Important independent variables included age, race, sex, and chronic disease status. Prior research has shown that health care charges are associated with these variables before and after adjustment for functional health status and other factors.
Age was calculated in years from date of birth to the date of the initial survey. Chronic disease status was determined based on data. Body mass index BMI was calculated as self-reported body weight in kilograms divided by self-reported height in meters squared, and was centered on its mean value.
Physical activity was assessed via self-report and quantified in relation to recommended guidelines. Those who reported ever having smoked at least cigarettes but denied currently smoking were defined as former smokers. Analytic Model We used a conditional probability 2-part model approach to study charges. The statistical properties of each model were systematically assessed in nested fashion. First, the significance of each individual partial regression coefficient was assessed using a t test.
This tested the hypothesis of whether an individual variable was related to variation in health care charges. Overweight employees were more likely to contribute costs to their employers due to higher injury claims than other workers.
There is an association between obesity and other modifiable health risks, such as hypertension, elevated serum cholesterol, physical inactivity, poor nutrition and diabetes mellitus Macdonald et al. However, it is unclear whether obesity itself is an independent risk factor or it merely contributes to the other major modifiable health risks Isozumi, Maintaining low-risk employees at their low-risk status can be as cost-effective as targeting high-risk employees.
As health risk is not static, workplace health programs need to address all levels of risk including the low-risk employees who may convert to high-risk status at some point in the future.
Reducing or preventing just one health risk increases a person's productivity and reduces absenteeism, disability and future health care utilization Musich et al. As health risks increase so do the indirect employer costs.
A study by Burton et al. These researchers calculated a 2. In fact, the indirect costs of poor health e. If employers are to implement appropriate interventions to help employees decrease their risk or, at minimum, maintain the same risk i. The purpose of this paper is to report on the health risk profile and prevalence of modifiable health risks in an Atlantic Canadian Employee Database. All employees were invited to participate in the onsite HRA. None of the participating organizations had workplace wellness programs at the time the HRAs were conducted.
A coordinator from each workplace recruited and organized employee participants for onsite health screening.
The coordinator used several methods to promote participation e. While participation was voluntary, employers encouraged employees to do the health screening. Written consent was obtained from all participants. The HRA consisted of collecting clinical data and completing a questionnaire at individual workplaces. Clinical data on modifiable health risks were collected by a trained team of health professionals, led by a registered nurse.
Measurements included blood pressure, blood cholesterol, weight, height and waist circumference.
Relationship Between Modifiable Health Risks and Short-term Health Care Charges
Employees completed the questionnaire by paper or online, with assistance as needed. The PWP is a tool used to prepare personal reports to guide individual health behaviour improvement, as well as group health reports to plan programs and develop organization-wide interventions. The PWP has been used in other studies Makrides et al.
Some of the strengths stated by the reviewers include the comprehensiveness of the tool and the fact that it is based on latest research, with constant updates as research knowledge changes. The PWP has an estimated content validity of 0. The collection of clinical data in the present study strengthens the reliability of the self-report questionnaire.
The PWP program compiles an individual report with a wellness score, health age and summary of scores related to individual health and lifestyle. Confidential individualized reports were mailed to employees in a sealed envelope.
The cost of modifiable health risk factors | The Incidental Economist
Employees who completed the online questionnaire generated their own personal report. Aggregate reports were given to the employers.
Descriptive statistics mean, range, standard deviation were calculated for five modifiable health risks: Smoking was defined as the proportion of employees who smoke cigarettes on a daily basis as derived from the PWP questionnaire responses.