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超重员工减肥对健康、生产力和医疗支出的影响。

The effect of weight loss on health, productivity, and medical expenditures among overweight employees.

机构信息

Health Services and Systems Research Program, Duke-NUS Graduate Medical School, Singapore.

出版信息

Med Care. 2013 Jun;51(6):471-7. doi: 10.1097/MLR.0b013e318286e437.

Abstract

OBJECTIVES

To test whether overweight or obese employees who achieve clinically significant weight loss of ≥ 5% have reduced medical expenditures, absenteeism, presenteeism, and/or improved Health-Related Quality Of Life (HRQOL).

METHODS

The sample analyzed combines data from full-time overweight or obese employees who took part in one of the WAY to Health weight loss studies: 1 that took place in 17 community colleges (935 employees) and another in 12 universities (933), all in North Carolina. The estimations are performed using nonlinear difference-in-difference models where groups are identified by whether the employee achieved a ≥ 5% weight loss (treated) or not (control) and the treatment variable indicates preweight and postweight loss intervention. The outcomes analyzed are the average quarterly (90 d) amount of medical claims paid by the health insurer, number of days missed at work during the past month, Stanford Presenteeism Scale SPS-6, and the EQ-5D-3L measure of HRQOL.

RESULTS

We find statistical evidence supporting that ≥ 5% weight loss prevents deterioration in EQ-5D-3L scores by 0.026 points (P-value=0.03) and reduces both absenteeism by 0.258 d/mo (P-value=0.093) and the likelihood of showing low presenteeism (Stanford SPS-6 score between 7 and 9) by 2.9 percentage points (P-value=0.083). No reduction in medical expenditures was observed.

CONCLUSIONS

Clinically significant weight loss among overweight or obese employees prevents short-term deterioration in HRQOL and there is some evidence that employee productivity is increased. We find no evidence of a quick return on investment from reduced medical expenditures, although this may occur over longer periods.

摘要

目的

检验体重超重或肥胖员工体重减轻≥5%是否能降低医疗支出、旷工、工作效率降低和/或提高健康相关生活质量(HRQOL)。

方法

本分析样本结合了参与 WAY to Health 减肥研究的全职超重或肥胖员工的数据:一项在北卡罗来纳州的 17 所社区学院(935 名员工)和另一项在 12 所大学(933 名员工)进行的研究。使用非线性差分模型进行估计,根据员工是否实现≥5%的体重减轻(处理组)或未实现(对照组)分组,处理变量表示体重减轻前和干预后的体重。分析的结果是由保险公司支付的平均季度(90 天)医疗费用、过去一个月旷工的天数、斯坦福表现量表 SPS-6 和 EQ-5D-3L 健康相关生活质量指标。

结果

我们发现有统计证据支持,≥5%的体重减轻可使 EQ-5D-3L 评分提高 0.026 分(P 值=0.03),旷工减少 0.258 天/月(P 值=0.093),斯坦福 SPS-6 评分在 7 到 9 之间的低工作效率可能性降低 2.9 个百分点(P 值=0.083)。没有观察到医疗支出的减少。

结论

超重或肥胖员工体重减轻达到临床显著水平可预防短期 HRQOL 恶化,并且有证据表明员工的工作效率提高。我们没有发现从减少医疗支出中获得快速投资回报的证据,尽管这种情况可能在较长时间内发生。

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