Prevalence rates and costs of metabolic syndrome and associated risk factors using employees' integrated laboratory data and health care claims.

OBJECTIVE: This study assessed the relative value of using laboratory, claims, or integrated laboratory-claims data to identify prevalence rates and costs of metabolic syndrome among Chevron Texaco Corporation, San Ramon, California, employees. METHODS: This study identified five metabolic syndrome risk factors by using three identification methods: (1) health-screening data, applying the National Cholesterol Education Program Adult Treatment Panel III and World Health Organization definitions; (2) employer-based claims data applying proxy International Classification of Diseases, 9th Revision definitions; and (3) integrated laboratory-claims data. Prevalence rates and costs of metabolic syndrome and associated risk factors were estimated. RESULTS: Laboratory-defined and claims-defined approaches underestimated metabolic syndrome prevalence rates compared with the integrated approach by 22.9% and 87.5%, respectively. Employees with metabolic syndrome had double the costs of those without any risk factors ($4603 vs $1859; P = 0.0384). CONCLUSIONS: Results suggest that integrating laboratory and claims data is a more balanced approach than either approach alone for identifying metabolic syndrome among Chevron employees.

Transitioning from a pen-and-paper health risk appraisal to an online health risk appraisal at a petroleum company.

Chevron Texaco's Health and Medical Services Department made the decision to use existing technology and transition from a paper health risk appraisal (HRA) to an online questionnaire. A cross-functional team was formed and a year was spent researching online tools to find a vendor who could supply a product best suited to Chevron Texaco's employee workforce. The purpose of this article is to describe the evolution of a paper-based HRA to an online tool as well as describe the project scope and strategy that a team of employees used in selecting the vendor. The article also describes implementation successes, challenges, and lessons learned in using the online tool with an industrial workforce. The strategy that was followed in deploying the Web site along with initial participation rates for this group of industrial employees are described.

A petroleum company's experience in implementing a comprehensive medical fitness for duty program for professional truck drivers.

Aggregate health risk appraisal data from Chevron Texaco's truck driver workforce revealed that approximately 50% of the truck drivers who completed a health risk appraisal were found to be at risk for a back injury. Lost time records revealed that this population had 65% more lost workdays attributed to cumulative trauma injuries compared with acute trauma injuries. Chevron Texaco addressed the issue by implementing a medical fitness for duty program consisting of three components: physical examination (physical examination mandated by the Department of Transportation and a functional capacity evaluation), education (on safe body mechanics), and physical fitness. After a 1-year development period, the fitness for duty program was implemented for Chevron Texaco's professional truck drivers in North America. In the first year of the program, 109 functional capacity evaluations were completed by trained clinicians, and 88% of candidates were found "able to work without restrictions," whereas 6% were found "able to work with caution." The article describes the program results to date, and also describes the follow-up program for drivers found to be at risk for a back injury.