David Hirschland

Influence of participation in a worksite health-promotion program on disability days

This study assessed the impact of health-promotion program participation on short-term and long-term disability absence days during a 6-year period in a manufacturing company. Male, hourly, active employees (n = 4189) were analyzed from 1995 to 2000. Disability absences were compared for program participants and nonparticipants from baseline (1995) through 5 years of the program. The percentage of nonparticipants absent on any given day was greater than that of participants. Moreover, the average number of disability absence days incurred by nonparticipants significantly increased from baseline to program year 5 compared with participants. The total amount saved each year in disability absence days for the 2596 program participants was

The Relationship between National Heart, Lung, and Blood Institute Weight Guidelines and Concurrent Medical Costs in a Manufacturing Population

623,040, which resulted in a savings-to-cost ratio of 2.3 per year. Participation in worksite health-promotion programs may lead to reduced disability days in a manufacturing worksite population.

Association between wellness score from a health risk appraisal and prospective medical claims costs.

Purpose. To explore the relationship between the 1998 National Heart, Lung, and Blood Institute (NHLBI) weight guidelines and concurrent medical costs. Design. Cross-sectional study. Setting. In a nationwide manufacturing corporation (General Motors Corporation). Subjects. A total of 177,971 employees, retirees, and their adult dependents who were enrolled in Indemnity/PPO health insurance plan during the years 1996 and 1997 and completed one health risk appraisal (HRA) in the same period. Measures. The participants were categorized into six weight groups according to the NHLBI 1998 guidelines (body mass index [BMI] <185, 185–24.9, 25–29.9, 30–34.9, 35–39.9, ≥40 kg/m2). The height and weight data were collected by self-reported values on an HRA or biometric screening completed during 1996 to 1997. To represent the typical medical costs in a given group, the median, instead of mean, medical charges were used in this article. The annual median medical charges (including drug charges) for years 1996 and 1997 were compared among the six weight groups by using Wilcoxon rank sum tests. The differences in median charges were also tested between the normal weight group and the other five groups for each of the 10 gender-age subgroups (five age groups: 19–44, 45–54, 55–64, 65–74, 75+). Results. Overall median medical costs were consistent with the NHLBI weight guidelines. The normal-weight group costs the least and both underweight and overweight-obesity groups cost more. The median medical costs of the six weight groups were

Examination of risk status transitions among active employees in a comprehensive worksite health promotion program.

3184,

Comparing excess costs across multiple corporate populations

2225,

Pattern of medical charges after quitting smoking among those with and without arthritis, allergies, or back pain.

2388,

Changes in health risks among the participants in the United Auto Workers--General Motors LifeSteps Health Promotion Program.

2801,

The UAW-GM health promotion program. Successful outcomes.

3182, and

Excess Healthcare Costs Associated with Excess Health Risks in Diseased and Non-Diseased Health Risk Appraisal Participants

3753, respectively, with statistical differences existing between any two groups of the last five categories. The underweight groups, especially in females, were not consistent with the guidelines in the two young groups (ages 19–44 and 45–54). An inconsistent relationship between medical costs and BMI groups was seen in the oldest males (age 75+). Conclusions. The six weight groups defined by the 1998 NHLBI guidelines are consistent with concurrent medical costs. Except for the underweight group (BMI < 18.5 kg/m2), medical costs gradually increased with BMI. Given that the prevalence of obesity continues to increase in western countries, effective weight control programs would help avoid a substantial amount of medical costs associated with overweight/obesity and related diseases.

Internal associations among health-risk factors and risk prevalence.

Learning ObjectivesExplain how the updated health risk appraisal used in this study differs from previous versions, and recall the components of the wellness score.Point out the predictive factors included in the multivariate regression model and note how successfully they explained the variance in medical claims costs.Recall the potential predictive factors that did - and those that did not - correlate significantly with actual medical claims costs, and those that were most predictive. This study examines how wellness scores generated from the Health Risk Appraisal are associated with prospective medical claims costs, controlling for age, gender, and disease status. The study was conducted among 19,861 active employees who participated in the Health Risk Appraisal and selected indemnity or PPO medical plans from 1996 to 1998. A multiple regression model based on group averages of age, gender, disease status, and wellness score levels was developed among a randomly selected screening subsample (n = 10,172) from the study sample. Total medical claim costs of −