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评估个体幸福感与未来医疗保健利用和成本之间的关系。

Evaluation of the relationship between individual well-being and future health care utilization and cost.

机构信息

Center for Health Research, Healthways, Inc, Franklin, TN 37067, USA.

出版信息

Popul Health Manag. 2012 Dec;15(6):325-30. doi: 10.1089/pop.2011.0089. Epub 2012 Feb 22.

Abstract

Escalating health care expenditures highlight the need to identify modifiable predictors of short-term utilization and cost. Thus, the predictive value of individual well-being scores was explored with respect to 1-year health care expenditures and hospital utilization among 2245 employees and members of a health plan who completed the Well-Being Assessment (WBA). The relationship between well-being scores and hospital admissions, emergency room (ER) visits, and medical and prescription expenditures 12-months post WBA was evaluated using multivariate statistical models controlling for participant characteristics and prior cost and utilization. An inverse relationship existed between well-being scores and all measured outcomes (P≤0.01). For every point increase in well-being on a 100-point scale, respondents were 2.2% less likely to have an admission, 1.7% less likely to have an ER visit, and 1.0% less likely to incur any health care costs. Among those who did incur cost, each point increase in well-being was associated with 1% less cost, and individuals with low well-being scores (≤50) had 2.7 times the median annual expenditure of individuals with high well-being (>75) ($5172 and $1885, respectively). Also, well-being proved lowest among respondents who incurred more than $20,000, and was highest among those who incurred ≤$5000, with median scores of 71.1 and 80.3, respectively. These results indicate that individual well-being is a strong predictor of important near-term health care outcomes. Thus, well-being improvement efforts represent a promising approach to decrease future health care utilization and expenditures.

摘要

不断攀升的医疗保健支出凸显出识别可改变的短期利用和成本预测因素的必要性。因此,在对参加了健康计划的 2245 名员工和成员完成的“健康评估”(WBA)中,对个人幸福感评分在一年内的医疗保健支出和医院利用率的预测价值进行了探索。在控制了参与者特征、先前的成本和利用情况后,使用多变量统计模型评估了幸福感评分与医院入院、急诊室(ER)就诊、医疗和处方支出之间的关系。幸福感评分与所有测量结果之间存在负相关关系(P≤0.01)。在 100 分制的幸福感评分中,每增加一分,受访者入院的可能性就会降低 2.2%,去急诊室就诊的可能性就会降低 1.7%,产生任何医疗保健费用的可能性就会降低 1.0%。对于那些确实产生了成本的人来说,幸福感每增加一分,成本就会降低 1%,幸福感得分较低(≤50)的人比幸福感得分较高(>75)的人年支出中位数高出 2.7 倍(分别为 5172 美元和 1885 美元)。此外,幸福感得分最低的是那些支出超过 20000 美元的受访者,而支出低于 5000 美元的受访者幸福感得分最高,中位数分别为 71.1 和 80.3。这些结果表明,个人幸福感是重要的近期医疗保健结果的有力预测因素。因此,幸福感改善努力代表了一种降低未来医疗保健利用和支出的有前途的方法。

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