University of Cape Town, Cape Town, South Africa.
Am J Health Promot. 2010 Jan-Feb;24(3):199-204. doi: 10.4278/090217-QUAN-68R2.1.
Examine the association between the levels of participation in an incentive-based health promotion program (Vitality) and inpatient medical claims among members of a major health insurer.
A 1-year, cross-sectional, correlational analyses of engagement with a health promotion program and hospital claims experience (admissions costs, days in hospital, and admission rate) of members of a national private health insurer.
Adult members of South Africa's largest national private health insurer, Discovery Health. Insured members were also eligible for voluntary membership in an insurance-linked incentivized health promotion program, Vitality.
The study sample included 948,974 adult members of the Discovery Health plan for the year 2006. Of these, 591,134 (62.3%) were also members of the Vitality health promotion program.
The study sample was grouped based on registration and the level of engagement with the Vitality health promotion program into the following: not registered (37.5%), registered but not engaged with any health promotion activity (21.9%), low engagement (30.9%), and high engagement (9.5%). High engagement was defined a priori by the accumulation of an arbitrary number of points on the Vitality program, allocated against specific activities (knowledge, fitness-related activities, assessment and screening, and healthy choices). Hospital admission costs, the number of days in hospital, and hospital admission rates were compared among highly engaged members and those members who were not enrolled in the program, nonengaged, and lowly engaged. Data were normalized for age, gender, plan type, and chronic disease status.
Highly engaged members had lower costs per patient, shorter stays in hospital, and fewer admissions compared with other groups (p < .001). Low or no engagement was not associated with lower hospital costs. Admission rates were also 7.4% lower for cardiovascular disease, 13.2% lower for cancers, and 20.7% lower for endocrine and metabolic diseases in the highly engaged group compared with any of the other groups (p < .01).
Engagement in an incentive-based wellness program, offered by a health insurer, was associated with lower health care costs.
研究参与基于激励的健康促进计划（活力计划）的程度与主要健康保险公司成员的住院医疗索赔之间的关联。
对参与健康促进计划的情况进行为期 1 年的横断面相关性分析，并对全国私人健康保险公司成员的医院索赔经验（住院费用、住院天数和入院率）进行分析。
南非最大的全国私人健康保险公司 Discovery Health 的成年会员。受保成员也有资格自愿加入与保险挂钩的激励性健康促进计划活力计划。
该研究样本包括 2006 年 Discovery Health 计划的 948974 名成年会员。其中，591134 名（62.3%）也是活力健康促进计划的成员。
根据在活力健康促进计划中的注册和参与程度，将研究样本分为以下几组：未注册（37.5%）、已注册但未参与任何健康促进活动（21.9%）、低参与度（30.9%）和高参与度（9.5%）。高参与度是通过在活力计划中积累任意数量的积分来预先定义的，这些积分是针对特定活动（知识、健身相关活动、评估和筛查以及健康选择）分配的。比较高参与度成员和未参加该计划的成员、不参与成员和低参与度成员的住院费用、住院天数和住院率。数据经过年龄、性别、计划类型和慢性病状况的正态化处理。
与其他组相比，高参与度成员的每位患者成本更低、住院时间更短、住院次数更少（p<0.001）。低参与度或不参与与较低的住院费用无关。与其他任何组相比，心血管疾病的入院率低 7.4%，癌症的入院率低 13.2%，内分泌和代谢疾病的入院率低 20.7%（p<0.01）。
参与由健康保险公司提供的基于激励的健康计划与降低医疗保健成本有关。
