Barriers to implementation of workplace health interventions: an economic perspective.

OBJECTIVE

To identify insurance related, structural, and workplace cultural barriers to the implementation of effective preventive and upstream clinical interventions in the working age adult population.

METHODS

Analysis of avoided costs from perspective of health economics theory and from empiric observations from large studies; presentation of data from our own cost-plus model on integrating health promotion and ergonomics.

RESULTS

We identify key avoided costs issues as a misalignment of interests between employers, insurers, service institutions, and government. Conceptual limitations of neoclassical economics are attributable to work culture and supply-driven nature of health care.

DISCUSSION

Effective valuation of avoided costs is a necessary condition for redirecting allocations and incentives. Key content for valuation models is discussed.