Highmark, Inc., Pittsburgh, Pennsylvania, USA.
Am J Health Promot. 2011 Mar-Apr;25(4):272-80. doi: 10.4278/ajhp.100415-QUAN-119.
Assess whether an insurer-provided Web-based wellness program results in cost and utilization improvements.
Quasi-experimental, pre-post, treatment-comparison design. Variables of interest were participation rates; medical, professional, and pharmacy expenditures; inpatient admissions; emergency room visits; and preventive service utilization.
Six hundred forty-three employer-based wellness programs in Pennsylvania.
Forty-seven employers engaged in the Web-based wellness program and 596 employers who were not engaged. The engaged employer group included 10,463 wellness participants; an equal number of matched nonparticipant employees were identified from employers who were not engaged.
Web-based wellness program features were added to an on-site program in 2004. The program was followed through 2007.
Outcomes were calculated using health insurance enrollment and claims history.
Participating employees were compared to nonparticipants using generalized linear mixed models to study changes in costs and utilization.
During the 2003 baseline year, engaged employers had greater costs, greater chronic disease prevalence, and greater hospitalization. Costs of program participants showed a lower rate of increase in 2004, and then dropped below those of the nonparticipants for the duration of the study. Between 2003 and 2007, the increase in medical expenditures of the participant group was significantly less than that of the nonparticipant group (31% vs. 46%, p < .01). In addition, the participant group showed a lower increase in professional service expenditures (p = .02) and greater utilization of preventive services (p < .01).
Web-based insurer-provided wellness programs may decrease health care costs and encourage preventive service utilization.
评估保险公司提供的基于网络的健康计划是否能带来成本和利用效率的改善。
准实验、前后测、对照设计。关注的变量有参与率、医疗、专业和药房支出、住院人数、急诊就诊次数和预防服务利用率。
宾夕法尼亚州 643 个雇主健康计划。
参与基于网络的健康计划的 47 个雇主和未参与的 596 个雇主。参与雇主组包括 10463 名健康计划参与者；从未参与的雇主中确定了数量相等的匹配非参与者员工。
2004 年在现场计划中增加了基于网络的健康计划功能。该计划一直持续到 2007 年。
使用健康保险登记和索赔记录计算结果。
使用广义线性混合模型比较参与员工和非参与员工，研究成本和利用率的变化。
在 2003 年基线年，参与雇主的成本更高，慢性病患病率更高，住院率也更高。2004 年，计划参与者的成本增长率较低，然后在研究期间低于非参与者的成本。在 2003 年至 2007 年期间，参与者组的医疗支出增长率明显低于非参与者组（31%对 46%，p<.01）。此外，参与者组的专业服务支出增长率较低（p=.02），预防服务利用率较高（p<.01）。
基于网络的保险公司提供的健康计划可能会降低医疗成本并鼓励预防服务的利用。
