Center for Health Research , Healthways, Inc, Franklin, Tennessee.
Popul Health Manag. 2014 Feb;17(1):13-20. doi: 10.1089/pop.2012.0120. Epub 2013 Apr 5.
The goal of this study was to determine the relationship between individual well-being and risk of a hospital event in the subsequent year. The authors hypothesized an inverse relationship in which low well-being predicts higher likelihood of hospital use. The study specifically sought to understand how well-being segments and demographic variables interact in defining risk of a hospital event (inpatient admission or emergency room visit) in an employed population. A retrospective study design was conducted with data from 8835 employees who completed a Well-Being Assessment questionnaire based on the Gallup-Healthways Well-Being Index. Cox proportional hazards models were used to examine the impact of Individual Well-Being Score (IWBS) segments and member demographics on hazard ratios (HRs) for a hospital event during the 12 months following assessment completion. Significant main effects were found for the influence of IWBS segments, sex, education, and relationship status on HRs of a hospital event, but not for age. However, further analysis revealed significant interactions between age and IWBS segments (P=0.005) and between age and sex (P<0.0001), indicating that the effects for IWBS segments and sex on HRs of a hospital event are mediated through their relationship with age. Overall, the strong relationship between low well-being and higher risk of an event in employees ages 44 years and older is mitigated in younger age groups. These results suggest that youth attenuates the risk engendered in poor well-being; therefore, methods to maintain or improve well-being as individuals age presents a strong opportunity for reducing hospital events.
这项研究的目的是确定个体幸福感与次年医院事件风险之间的关系。作者假设存在一种相反的关系,即低幸福感预示着更高的医院使用可能性。该研究特别旨在了解幸福感细分和人口统计学变量如何相互作用,以确定就业人群中医院事件(住院或急诊就诊)的风险。对 8835 名完成基于盖洛普-健康之路幸福感指数的幸福感评估问卷的员工进行了回顾性研究设计。使用 Cox 比例风险模型来检查个体幸福感评分 (IWBS) 段和成员人口统计学数据对评估完成后 12 个月内医院事件的风险比 (HR) 的影响。发现 IWBS 段、性别、教育程度和关系状况对医院事件的 HR 有显著的主要影响,但年龄没有。然而,进一步的分析显示,年龄和 IWBS 段之间(P=0.005)以及年龄和性别之间(P<0.0001)存在显著的交互作用,表明 IWBS 段和性别对医院事件的 HR 影响是通过它们与年龄的关系来介导的。总的来说,在 44 岁及以上的员工中,低幸福感与更高的事件风险之间存在很强的关系,但在年轻的年龄组中,这种关系有所减弱。这些结果表明,年轻人减轻了不良幸福感带来的风险;因此,随着个人年龄的增长,保持或改善幸福感的方法为减少医院事件提供了一个强有力的机会。