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1.
J Occup Environ Med ; 60(11): 968-978, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30407366

RESUMO

OBJECTIVE: There is growing interest in the NIOSH Total Worker Health program, specifically in the process of designing and implementing safer, health-promoting work and workplaces. A Total Worker Health (TWH) Research Methodology Workshop was convened to discuss research methods and future needs. METHODS: Twenty-six experts in occupational safety and health and related fields reviewed and discussed current methodological and measurement issues and those showing promise. RESULTS: TWH intervention studies face the same challenges as other workplace intervention studies and some unique ones. Examples are provided of different approaches and their applications to TWH intervention studies, and desired developments in the TWH literature. CONCLUSIONS: This report discusses and outlines principles important to building the TWH intervention research base. Rigorous, valid methodologic, and measurement approaches are needed for TWH intervention as well as for basic/etiologic, translational, and surveillance research.


Assuntos
Promoção da Saúde/métodos , Saúde do Trabalhador , Desenvolvimento de Programas/métodos , Avaliação de Programas e Projetos de Saúde/métodos , Projetos de Pesquisa , Humanos , Estudos de Casos Organizacionais/métodos , Pesquisa Qualitativa , Viés de Seleção , Local de Trabalho
2.
Popul Health Manag ; 20(3): 181-188, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-27575977

RESUMO

Wellness programs are designed to help individuals maintain or improve their health. This article describes how a reporting process can be used to help manage and improve a wellness program. Beginning in 2014, a wellness pilot program became available in New Jersey for individuals with an AARP Medicare Supplement Insurance plan insured by UnitedHealthcare Insurance Company. The program has since expanded to include Missouri, Texas, Alabama, and Washington. This wellness program includes an online health portal, one-on-one telephonic coaching, gym membership discounts, and local health events. To assure smooth program operations and alignment with program objectives, weekly and monthly reports are produced. The weekly report includes metrics on member engagement and utilization for the aforementioned 4 program offerings and reports on the last 4 weeks, as well as for the current month and the current year to date. The monthly report includes separate worksheets for each state and a summary worksheet that includes all states combined, and provides metrics on overall engagement as well as utilization of the 4 program components. Although the monthly reports were used to better manage the 4 program offerings, the weekly reports help management to gauge response to program marketing. Reporting can be a data-driven management tool to help manage wellness programs. Reports provide rapid feedback regarding program performance. In contrast, in-depth program evaluations serve a different purpose, such as to report program-related savings, return on investment, or to report other longer term program-related outcomes.


Assuntos
Promoção da Saúde/estatística & dados numéricos , Promoção da Saúde/normas , Avaliação de Programas e Projetos de Saúde , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Melhoria de Qualidade , Estados Unidos
3.
Popul Health Manag ; 20(2): 114-122, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27419470

RESUMO

The objective of this study was to estimate the prevalence of health risk factors by sexual orientation over a 4-year period within a sample of employees from a large firm. Propensity score-weighted generalized linear regression models were used to estimate the proportion of employees at high risk for health problems in each year and over time, controlling for many factors. Analyses were conducted with 6 study samples based on sex and sexual orientation. Rates of smoking, stress, and certain other health risk factors were higher for lesbian, gay, and bisexual (LGB) employees compared with rates of these risks among straight employees. Lesbian, gay, and straight employees successfully reduced risk levels in many areas. Significant reductions were realized for the proportion at risk for high stress and low life satisfaction among gay and lesbian employees, and for the proportion of smokers among gay males. Comparing changes over time for sexual orientation groups versus other employee groups showed that improvements and reductions in risk levels for most health risk factors examined occurred at similar rates among individuals employed by this firm, regardless of sexual orientation. These results can help improve understanding of LGB health and provide information on where to focus workplace health promotion efforts to meet the health needs of LGB employees.


Assuntos
Dieta/estatística & dados numéricos , Saúde/estatística & dados numéricos , Sexualidade/estatística & dados numéricos , Estresse Psicológico/epidemiologia , Pressão Sanguínea , Índice de Massa Corporal , Exercício , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Fumar/epidemiologia
4.
J Occup Environ Med ; 58(9): 896-901, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27414014

RESUMO

OBJECTIVE: Using health plan membership as a proxy for employee retention, the objective of this study was to examine whether use of health promotion programs was associated with employee retention. METHODS: Propensity score weighted generalized linear regression models were used to estimate the association between telephonic programs or health risk surveys and retention. Analyses were conducted with six study samples based on type of program participation. RESULTS: Retention rates were highest for employees with either telephonic program activity or health risk surveys and lowest for employees who did not participate in any interventions. Participants ranged from 71% more likely to 5% less likely to remain with their employers compared with nonparticipants, depending on the sample used in analyses. CONCLUSIONS: Using health promotion programs in combination with health risk surveys may lead to improvements in employee retention.


Assuntos
Promoção da Saúde/métodos , Reorganização de Recursos Humanos , Local de Trabalho , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , Estudos Retrospectivos , Telefone
5.
J Ambul Care Manage ; 39(3): 186-98, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27232680

RESUMO

Propensity to succeed modeling was used to identify characteristics associated with higher utilization of a telephone triage program and adherence to nurse recommendations among callers. Characteristics significantly associated with calling the telephone triage service and engaging in triage services were being female and having an elevated health risk score. Callers most likely to adhere to nurse recommendations were younger than 85 years of age, had called on a weekday, and had received a recommendation to seek care at an emergency department or a doctor's office visit. Additional analyses suggest the propensity to succeed modeling is stable and valid.


Assuntos
Linhas Diretas/estatística & dados numéricos , Recursos Humanos de Enfermagem , Cooperação do Paciente , Triagem/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Aconselhamento , Feminino , Humanos , Masculino , Medicare , Estados Unidos
7.
Popul Health Manag ; 19(5): 315-23, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-26760079

RESUMO

Regular physical activity is strongly linked to prevention of costly chronic health conditions. However, there has been limited examination of the impact that level of participation in physical activity promotion programs has on health care costs. This study examined a fitness reimbursement program (FRP) offered to small employers. FRP participants received $20 reimbursement every month they visited their fitness center ≥12 days. Visits were recorded electronically. Participants were assigned to 4 mutually exclusive cohorts by mean monthly fitness center visits: low (<4 visits); low-moderate (≥4 and <8 visits), high-moderate (≥8 and <12 visits), and high (≥12 visits, which qualified for reimbursement). Cohorts were matched by inverse propensity score weighting on demographic, health status, health care supply, and socioeconomic characteristics. Between-cohort differences in propensity score-weighted health care costs, starting from FRP program sign-up, were examined with a generalized linear model. Analyses were conducted with and without high-cost outliers during the pre- and post-FRP period. A total of 8723 participants (mean follow-up: 11.1 months) were identified during October 2010-June 2013. With high-cost outliers removed (n = 226), a pattern of lower per-member-per-month health care costs was observed with increasing participation: compared with the low cohort, monthly savings were: $6.14 (2.6%) for low-moderate (P = 0.60), $16.40 (6.9%) for moderate-high (P = 0.16), and $20.01 (8.4%) for high (P = 0.08). With high-cost outliers included, significant monthly cost savings were observed for the moderate-high ($43.52, P < 0.01) and high ($52.66, P < 0.001) cohorts. These results indicate directionally positive cost outcomes associated with increasing level of fitness center participation.


Assuntos
Exercício , Academias de Ginástica/estatística & dados numéricos , Gastos em Saúde/tendências , Promoção da Saúde/economia , Adulto , Feminino , Planos de Assistência de Saúde para Empregados , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
8.
J Occup Environ Med ; 57(10): 1119-26, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26461868

RESUMO

OBJECTIVE: To assess the relationship between wellness program participation and employee health risks. METHODS: Data from 173,901 health-risk appraisals and wellness program participation records were used to assess changes in seven health risks (blood pressure, body weight, cholesterol level, nutrition, physical inactivity, stress, and tobacco use). RESULTS: Controlling for baseline covariates, high-risk members who completed only a coaching program were significantly more likely to lower five out of seven health risks than were high-risk members in the comparison group. Participation in multiple wellness activities (eg, biometric screening) increased the odds that risks would be reduced.In addition, the number of risk levels that improved was greater than the total that worsened. CONCLUSIONS: This study provides evidence that wellness program participation was associated with significant risk reduction, particularly among individuals who participated in more than one program.


Assuntos
Comportamentos Relacionados com a Saúde , Promoção da Saúde/estatística & dados numéricos , Indicadores Básicos de Saúde , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Saúde do Trabalhador/estatística & dados numéricos , Comportamento de Redução do Risco , Adolescente , Adulto , Feminino , Promoção da Saúde/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Serviços de Saúde do Trabalhador/métodos , Medição de Risco , Autorrelato , Estados Unidos , Adulto Jovem
9.
Popul Health Manag ; 18(6): 402-11, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25658872

RESUMO

The objective was to develop a propensity to succeed (PTS) process for prioritizing outreach to individuals with Medicare Supplement (ie, Medigap) plans who qualified for a high-risk case management (HRCM) program. Demographic, socioeconomic, health status, and local health care supply data from previous HRCM program participants and nonparticipants were obtained from Medigap membership and health care claims data and public data sources. Three logistic regression models were estimated to find members with higher probabilities of engaging in the HRCM program, receiving high quality of care once engaged, and incurring enough monetary savings related to program participation to more than offset program costs. The logistic regression model intercepts and coefficients yielded the information required to build predictive models that were then applied to generate predicted probabilities of program engagement, high quality of care, and cost savings a priori for different members who later qualified for the HRCM program. Predicted probabilities from the engagement and cost models were then standardized and combined to obtain an overall PTS score, which was sorted from highest to lowest and used to prioritize outreach efforts to those newly eligible for the HRCM program. The validity of the predictive models also was estimated. The PTS models for engagement and financial savings were statistically valid. The combined PTS score based on those 2 components helped prioritize outreach to individuals who qualified for the HRCM program. Using PTS models may help increase program engagement and financial success of care coordination programs.


Assuntos
Administração de Caso/economia , Medicare/economia , Avaliação de Programas e Projetos de Saúde , Idoso , Idoso de 80 Anos ou mais , Redução de Custos , Feminino , Humanos , Masculino , Estados Unidos
10.
Big Data ; 3(2): 114-25, 2015 06.
Artigo em Inglês | MEDLINE | ID: mdl-27447434

RESUMO

Most healthcare data warehouses include big data such as health plan, medical, and pharmacy claims information for many thousands and sometimes millions of insured individuals. This makes it possible to identify those with multiple chronic conditions who may benefit from participation in care coordination programs meant to improve their health. The objective of this article is to describe how large databases, including individual and claims data, and other, smaller types of data from surveys and personal interviews, are used to support a care coordination program. The program described in this study was implemented for adults who are generally 65 years of age or older and have an AARP(®) Medicare Supplement Insurance Plan (i.e., a Medigap plan) insured by UnitedHealthcare Insurance Company (or, for New York residents, UnitedHealthcare Insurance Company of New York). Individual and claims data were used first to calculate risk scores that were then utilized to identify the majority of individuals who were qualified for program participation. For efficient use of time and resources, propensity to succeed modeling was used to prioritize referrals based upon their predicted probabilities of (1) engaging in the care coordination program, (2) saving money once engaged, and (3) receiving higher quality of care. To date, program evaluations have reported positive returns on investment and improved quality of healthcare among program participants. In conclusion, the use of data sources big and small can help guide program operations and determine if care coordination programs are working to help older adults live healthier lives.


Assuntos
Seguro de Saúde (Situações Limítrofes)/estatística & dados numéricos , Medicare/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Interpretação Estatística de Dados , Assistência à Saúde/economia , Assistência à Saúde/estatística & dados numéricos , Feminino , Humanos , Masculino , Modelos Estatísticos , New York , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Qualidade da Assistência à Saúde , Estados Unidos
11.
Popul Health Manag ; 18(2): 93-103, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25188893

RESUMO

The objective was to evaluate the 3-year experience of a high-risk case management (HRCM) pilot program for adults with an AARP Medicare Supplement (Medigap) Insurance Plan. Participants were provided in-person visits as well as telephonic and mailed services to improve care coordination from December 1, 2008, to December 31, 2011. Included were adults who had an AARP Medigap Insurance Plan, resided in 1 of 5 pilot states, and had a Hierarchical Condition Category score>3.74, or were referred into the program. Propensity score weighting was used to adjust for case-mix differences among 2015 participants and 7626 qualified but nonparticipating individuals. Participants were in the program an average of 15.4 months. After weighting, multiple regression analyses were used to estimate differences in quality of care and health care expenditures between participants and nonparticipants. Increased duration in the program was associated with fewer hospital readmissions. Additionally, participants were significantly more likely to have recurring office visits and recommended laboratory tests. The program demonstrated $7.7 million in savings over the 3 years, resulting in a return on investment of $1.40 saved for every dollar spent on the program. Savings increased each year from 2009 to 2011 and with longer length of engagement. The majority of savings were realized by the federal Medicare program. This study focused on quality of care and savings for an HRCM program designed solely for Medicare members with Medicare Supplement coverage. This program had a favorable impact on quality of care and demonstrated savings over a 3-year period.


Assuntos
Administração de Caso/economia , Gastos em Saúde , Seguro de Saúde (Situações Limítrofes)/economia , Medicare/economia , Gestão de Riscos/organização & administração , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Projetos Piloto , Estudos Retrospectivos , Estados Unidos
12.
Prof Case Manag ; 19(5): 216-23, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25084076

RESUMO

PURPOSE OF THE STUDY: To find out why individuals choose to engage, disengage, or not to engage in care coordination programs that are meant to improve their health and better navigate the medical care system. PRIMARY PRACTICE SETTING: Care coordination program designed for individuals with an AARP Medicare Supplement Insurance Plan. METHODOLOGY AND SAMPLE: A 2-phase study was used involving insureds eligible for disease, depression, or case management programs. The study focused on those who participated in these programs (i.e., the engaged group), those who left the programs after starting their participation (the disengaged group), and those who never engaged in these programs. A telephone survey was conducted first, followed by focus groups and in-depth telephone interviews to address interesting findings from the survey. RESULTS: The top reasons for program engagement included believing that the program would be helpful (39%), liking its convenience (14%), and because participation was at no additional cost (9%). The top reasons for not engaging included not seeing potential benefit from engagement (28%) and being comfortable with current health care processes (19%). Reasons given for disengaging included lack of time (15%), not believing the program was helpful (13%), not understanding what the program provided (13%), or being unaware of the program (11%). Among the key findings from the focus groups were that individuals who felt they were not getting sufficient support from their medical providers or those needing a sounding board were more likely to engage. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: This study provides valuable insight regarding how to best engage individuals with such a plan and who are qualified for care coordination programs. These results suggest that those most motivated to engage are those who are well informed of the program benefits and have a perceived need, such as living alone and needing a sounding board.


Assuntos
Continuidade da Assistência ao Paciente , Idoso , Idoso de 80 Anos ou mais , Administração de Caso , Humanos , Medicare , Projetos Piloto , Inquéritos e Questionários , Estados Unidos
13.
J Telemed Telecare ; 20(6): 330-8, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25059246

RESUMO

Telephone nurse lines help callers to select the most appropriate site and level of care for acute conditions. We examined whether compliance with nurse recommendations was associated with lower average health care expenditure, and identified the employer characteristics associated with higher than average savings. Telephone calls to a nurse-led help line made by commercial health plan members who worked for large employers were identified. The callers' intention before calling and the nurse recommendation regarding site/level of care were recorded. Compliance was determined using medical claims during a 30-day post-call observation period and was based on adherence to nurse recommendations. A total of 132,509 calls during 2012 were identified for the study. Nurse recommendations were that 31% of the callers seek a higher level of care than mentioned at the start of the call, 25% use a lower level of care and 44% pursue their originally intended level of care. After regression-based adjustment, the average medical expenditures were compared between compliers and non-compliers. Overall, 57% of callers were compliant with nurse recommendations. The average expenditures were $328 lower among compliant callers. A logistic regression analysis identified employer characteristics positively associated with achieving higher than average savings. These were having a low employee-to-dependent ratio, a headquarters in the Western region of the US, a low prospective health risk score, and participation by the employer in a targeted communication campaign. Compliance with the triage recommendations resulted in lower average health care expenditures, and several characteristics were positively associated with achieving higher savings.


Assuntos
Custos de Cuidados de Saúde/estatística & dados numéricos , Linhas Diretas , Consulta Remota/métodos , Triagem/economia , Adolescente , Adulto , Criança , Pré-Escolar , Comunicação , Feminino , Linhas Diretas/economia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Relações Enfermeiro-Paciente , Pesquisa em Avaliação de Enfermagem , Cooperação do Paciente/estatística & dados numéricos , Satisfação do Paciente , Padrões de Prática em Enfermagem/estatística & dados numéricos , Estudos Prospectivos , Consulta Remota/economia , Triagem/organização & administração , Triagem/normas , Adulto Jovem
14.
Popul Health Manag ; 17(5): 297-305, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24892950

RESUMO

The objective of this study was to estimate the association between changes in health care expenditures relative to changes in health risk status for employers of all sizes. Repeat health risk assessments (HRAs) were obtained from 50,005 employees and spouses with 2 years of health plan enrollment, and from 37,559 employees and spouses with 3 years of enrollment in employer-sponsored medical coverage. Changes in health care expenditures were measured from the year before completion of the first HRA to the years before and after the completion of the second HRA. Propensity score weighting was used to adjust for those who did not repeat the HRA so results could be extrapolated to the larger population. Propensity score weighted multiple regression analyses were used to estimate the relationship between changes in health care expenditures with changes in risk status for 9 risk categories. Significantly higher health care expenditures were associated with those who moved from low risk to medium or high risk, compared to those who remained low risk. Expenditure reductions estimated for those who improved their health status from high risk to medium or low risk were not statistically significant. This study is unique because of its large sample size, its use of data from a wide range of employer sizes, and its efforts to extend generalizability to those who did not complete both HRAs. These results demonstrate that the potential for short-term health care savings may be greater for programs that help maintain low risk than for programs focused on risk reduction.


Assuntos
Custos de Saúde para o Empregador , Planos de Assistência de Saúde para Empregados , Gastos em Saúde , Adolescente , Adulto , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , Estudos Retrospectivos , Medição de Risco , Adulto Jovem
15.
Popul Health Manag ; 17(5): 257-64, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24865849

RESUMO

The objective of this study was to evaluate an Emergency Room having a Decision-Support (ERDS) program designed to appropriately reduce ER use among frequent users, defined as 3 or more visits within a 12-month period. To achieve this, adults with an AARP Medicare Supplement Insurance plan insured by UnitedHealthcare Insurance Company (for New York residents, UnitedHealthcare Insurance Company of New York) were eligible to participate in the program. These included 7070 individuals who elected to enroll in the ERDS program and an equal number of matched nonparticipants who were eligible but either declined or were unreachable. Program-related benefits were estimated by comparing the difference in downstream health care utilization and expenditures between engaged and not engaged individuals after using propensity score matching to adjust for case mix differences between these groups. As a result, compared with the not engaged, engaged individuals experienced better care coordination, evidenced by a greater reduction in ER visits (P=0.033) and hospital admissions (P=0.002) and an increase in office visits (P<0.001). The program was cost-effective, with a return on investment (ROI) of 1.24, which was calculated by dividing the total program savings ($3.41 million) by the total program costs ($2.75 million). The ROI implies that for every dollar invested in this program, $1.24 was saved, most of which was for the federal Medicare program. In conclusion, the decrease in ER visits and hospital admissions and the increase in office visits may indicate the program helped individuals to seek the appropriate levels of care.


Assuntos
Técnicas de Apoio para a Decisão , Serviço Hospitalar de Emergência/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Visita a Consultório Médico/estatística & dados numéricos , Participação do Paciente , Idoso , Análise Custo-Benefício , Feminino , Humanos , Masculino , Medicare , Avaliação de Programas e Projetos de Saúde , Estados Unidos
16.
J Women Aging ; 26(2): 146-59, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24713053

RESUMO

Numerous barriers to managing coronary artery disease (CAD) among older women are reported in the literature; however, few studies adjust for demographic and health status differences. A survey assessing barriers and other factors was distributed to a stratified random sampling of older women with CAD. Factor analysis and multiple logistic regression procedures were used to estimate the impact of these issues on receiving a CAD-related office visit. The most problematic barriers included denial and low health literacy. Efforts to promote patient awareness of heart health and better communication between patients and clinicians may alleviate these barriers.


Assuntos
Atitude Frente a Saúde , Doença da Artéria Coronariana/terapia , Acesso aos Serviços de Saúde , Saúde da Mulher , Idoso , Idoso de 80 Anos ou mais , Feminino , Alfabetização em Saúde , Promoção da Saúde , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Relações Médico-Paciente
17.
J Nurs Manag ; 22(7): 837-47, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23607510

RESUMO

AIM: To estimate the relationship between adherence to nurse recommendations about where to seek care and expenditures for health-care services received by callers to a Nurse HealthLine telephone-based triage programme. METHODS: Health-care utilization and claims data from callers to the Nurse HealthLine were included. Adherent callers were those who followed the nurse recommendations, while those who did not were classified as non-adherent. Programme-related savings were estimated using differences in downstream health-care expenditures between adherent and non-adherent callers after using multivariate modelling to adjust for between-group differences. RESULTS: Fifty-five per cent of callers were adherent. Nurses were over three times as likely (41% vs. 13%) to recommend seeking a higher level of care (e.g. emergency room vs. urgent care). Regression analyses showed that the impact of getting members to the appropriate place of care was associated with significant annual savings of $13.8 million (P < 0.05), attributable mostly to Medicare, generating a positive return on investment of $1.59. CONCLUSIONS: This is the first known Nurse HealthLine triage programme exclusively for Medicare beneficiaries with supplemental coverage. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should consider promoting telephone-based triage programmes as complementary to clinical nursing, which has a direct impact on health-care utilization and costs.


Assuntos
Redução de Custos/métodos , Relações Enfermeiro-Paciente , Cooperação do Paciente/estatística & dados numéricos , Consulta Remota/economia , Telefone/estatística & dados numéricos , Triagem/métodos , Comunicação , Custos de Cuidados de Saúde/estatística & dados numéricos , Humanos , Pesquisa em Avaliação de Enfermagem , Consulta Remota/métodos , Triagem/economia , Triagem/normas
18.
J Occup Environ Med ; 55(10): 1142-8, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24100855

RESUMO

OBJECTIVE: The objective of this study was to estimate productivity-related savings associated with employee participation in health promotion programs. METHODS: Propensity score weighting and multiple regression techniques were used to estimate savings. These techniques were adjusted for demographic and health status differences between participants who engaged in one or more telephonic health management programs and nonparticipants who were eligible for but did not engage in these programs. RESULTS: Employees who participated in a program and successfully improved their health care or lifestyle showed significant improvements in lost work time. These employees saved an average of $353 per person per year. This reflects about 10.3 hours in additional productive time annually, compared with similar, but nonparticipating employees. CONCLUSIONS: Participating in health promotion programs can help improve productivity levels among employees and save money for their employers.


Assuntos
Eficiência , Promoção da Saúde/métodos , Local de Trabalho/economia , Absenteísmo , Adulto , Feminino , Nível de Saúde , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Pontuação de Propensão , Sensibilidade e Especificidade , Local de Trabalho/estatística & dados numéricos
19.
J Occup Environ Med ; 55(10): 1179-85, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24064775

RESUMO

OBJECTIVE: To evaluate the association between health risks and health care expenditures for employers of all sizes, generalizing to all employees, even those who did not complete a health risk assessment (HRA). METHODS: Health risk assessments were obtained from 169,693 insured employees and spouses. Total health care expenditures were measured before HRA completion. Propensity score weighting, adjusting for HRA nonresponse, and multivariate regression analyses were used to estimate the relationship between health risks and health care expenditures. RESULTS: These at-risk categories were significantly associated with increased health care expenditures: elevated blood pressure, body weight and cholesterol, medication/drug use for relaxation, physical inactivity, and stress. CONCLUSIONS: The large sample size, the use of data from small firms, and generalizability made this study unique. Targeted programs that promote management of health risks could result in health care cost savings for employers of all sizes.


Assuntos
Custos de Saúde para o Empregador/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Custos de Cuidados de Saúde/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , Análise de Regressão , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Adulto Jovem
20.
J Gerontol Nurs ; 39(6): 32-44, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23607262

RESUMO

Pain is a frequent and debilitating problem among older adults, decreasing quality of life (QOL) both physically and mentally. The burden of arthritis, sciatica, and back pain on QOL was estimated using ordinary least squares regression techniques to estimate the impact of each of these types of pain on QOL, controlling for patient demographic, socioeconomic, and health status characteristics. For individuals with arthritis, sciatica, and back pain, the adjusted average physical component scores were 4.19, 1.39, and 6.75 points lower, respectively (all p < 0.0001), than those without pain. Adjusted average mental component scores were 1.33, 0.47, and 2.93 points lower (all p < 0.01) for individuals with arthritis, sciatica, and back pain, respectively. The impact of pain on QOL was greater than that for many other commonly treated medical conditions. Clinicians should discuss pain with their patients to maximize their QOL.


Assuntos
Transtornos Cognitivos , Dor/fisiopatologia , Qualidade de Vida , Idoso , Doença Crônica , Humanos , Dor/psicologia
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