Dalal Karl, Khoury Allan, Nyce Steve
Benefits Q. 2014;30(4):55-67.
Employers need to control health costs while also keeping their workers healthy, productive and on the job. To those ends, BP America leased space to a full-service health and wellness center clinic on its Houston West-Lake campus, where rates of asthma, diabetes, coronary artery disease and other chronic conditions are high. Despite growing interest in worksite clinics, there is remarkably little quantifiable evidence demonstrating their value. This study uses a comprehensive value-chain approach to compare utilization, clinical outcomes and medical and pharmacy costs for medical center users and nonusers in Houston and other BP locations. Return on investment is also estimated. Overall utilization at the WestLake campus spiked in the 2012 plan year, pushing medical and pharmacy cost trends higher and highlighting the importance of shifting community-delivered services to the worksite medical center. Medical center users had fewer emergency room, inpatient hospital and outpatient hospital visits than nonusers as well as higher generic dispensing rates. While ROI fell slightly short of the break-even point in the medical center's first year based on an "intent to treat" methodology, indicators suggest that utilization and outcomes are moving in the desired direction.
雇主需要控制医疗成本,同时还要让员工保持健康、高效工作并坚守岗位。为此,美国BP公司在其位于休斯顿西湖园区的场地租赁空间,设立了一家提供全方位服务的健康与保健中心诊所,该园区哮喘、糖尿病、冠状动脉疾病及其他慢性病的发病率很高。尽管对工作场所诊所的兴趣日益浓厚,但能证明其价值的可量化证据却非常少。本研究采用全面的价值链方法,比较休斯顿及BP公司其他地点医疗中心使用者和非使用者的医疗服务利用率、临床结果以及医疗和药品成本。同时还估算了投资回报率。西湖园区在2012计划年度的整体利用率大幅上升,推动医疗和药品成本趋势上升,凸显了将社区提供的服务转移至工作场所医疗中心的重要性。医疗中心使用者的急诊室、住院和门诊就诊次数均少于非使用者,且通用药品配药率更高。虽然基于“意向性治疗”方法,该医疗中心第一年的投资回报率略低于盈亏平衡点,但各项指标表明,利用率和治疗效果正朝着预期方向发展。