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十种可改变的健康风险因素与员工医疗成本——更新版。

Ten Modifiable Health Risk Factors and Employees' Medical Costs-An Update.

机构信息

Institute for Health and Productivity Studies, Johns Hopkins Bloomberg School of Public Health, Bethesda, MD, USA.

IBM Watson Health, Bethesda, MD, USA.

出版信息

Am J Health Promot. 2020 Jun;34(5):490-499. doi: 10.1177/0890117120917850. Epub 2020 Apr 15.

Abstract

PURPOSE

To estimate the relationship between employees' health risks and health-care costs to inform health promotion program design.

DESIGN

An observational study of person-level health-care claims and health risk assessment (HRA) data that used regression models to estimate the relationship between 10 modifiable risk factors and subsequent year 1 health-care costs.

SETTING

United States.

PARTICIPANTS

The sample included active, full-time, adult employees continuously enrolled in employer-sponsored health insurance plans contributing to IBM MarketScan Research Databases who completed an HRA. Study criteria were met by 135 219 employees from 11 employers.

MEASURES

Ten modifiable risk factors and individual sociodemographic and health characteristics were included in the models as independent variables. Five settings of health-care costs were outcomes in addition to total expenditures.

ANALYSIS

After building the analytic file, we estimated generalized linear models and conducted postestimation bootstrapping.

RESULTS

Health-care costs were significantly higher for employees at higher risk for blood glucose, obesity, stress, depression, and physical inactivity (all at < .0001) than for those at lower risk. Similar cost differentials were found when specific health-care services were examined.

CONCLUSION

Employers may achieve cost savings in the short run by implementing comprehensive health promotion programs that focus on decreasing multiple health risks.

摘要

目的

评估员工健康风险与医疗保健成本之间的关系,为健康促进计划的设计提供信息。

设计

一项观察性研究,基于个人的医疗保健索赔和健康风险评估(HRA)数据,使用回归模型估计 10 个可改变的风险因素与随后一年的医疗保健成本之间的关系。

地点

美国。

参与者

该样本包括连续参加雇主赞助的健康保险计划并为 IBM MarketScan 研究数据库做出贡献的活跃、全职、成年员工,他们完成了 HRA。有 11 家雇主的 135219 名员工符合研究标准。

测量方法

10 个可改变的风险因素以及个体社会人口统计学和健康特征被纳入模型作为自变量。除了总支出外,还有五种医疗保健成本设置作为结果。

分析

在构建分析文件后,我们估计了广义线性模型,并进行了事后估计 bootstrap 分析。

结果

血糖、肥胖、压力、抑郁和体力活动不足风险较高的员工的医疗保健成本明显高于风险较低的员工(均<0.0001)。当检查特定的医疗服务时,也发现了类似的成本差异。

结论

雇主通过实施关注降低多种健康风险的综合健康促进计划,可能会在短期内实现成本节约。

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