The Relationship Between Modifiable Health Risks and Health Care Expenditures
- 1 October 1998
- journal article
- research article
- Published by Wolters Kluwer Health in Journal of Occupational and Environmental Medicine
- Vol. 40 (10) , 843-854
- https://doi.org/10.1097/00043764-199810000-00003
Abstract
This investigation estimates the impact of ten modifiable health risk behaviors and measures and their impact on health care expenditures, controlling for other measured risk and demographic factors. Retrospective two-stage multivariate analyses, including logistic and linear regression models, were used to follow up 46,026 employees from six large health care purchasers for up to 3 years after they completed an initial health risk appraisal. These participants contributed 113,963 person-years of experience. Results show that employees at high risk for poor health outcomes had significantly higher expenditures than did subjects at lower risk in seven of ten risk categories: those who reported themselves as depressed (70% higher expenditures), at high stress (46%), with high blood glucose levels (35%), at extremely high or low body weight (21%), former (20%) and current (14%) tobacco users, with high blood pressure (12%), and with sedentary lifestyle (10%). These same risk factors were found to be associated with a higher likelihood of having extremely high (outlier) expenditures. Employees with multiple risk profiles for specific disease outcomes had higher expenditures than did those without these profiles for the following diseases: heart disease (228% higher expenditures), psychosocial problems (147%), and stroke (85%). Compared with prior studies, the results provide more precise estimates of the incremental medical expenditures associated with common modifiable risk factors after we controlled for multiple risk conditions and demographic confounders. The authors conclude that common modifiable health risks are associated with short-term increases in the likelihood of incurring health expenditures and in the magnitude of those expenditures.Keywords
This publication has 11 references indexed in Scilit:
- A Review of Health-Related Outcomes of Multi-Component Worksite Health Promotion ProgramsAmerican Journal of Health Promotion, 1997
- A Review and Analysis of the Health and Cost-Effective Outcome Studies of Comprehensive Health Promotion and Disease Prevention Programs at the Worksite: 1993–1995 UpdateAmerican Journal of Health Promotion, 1996
- Physical Activity and Public HealthJAMA, 1995
- A Review and Analysis of the Health and Cost-Effective Outcome Studies of Comprehensive Health Promotion and Disease Prevention Programs at the Worksite: 1991–1993 UpdateAmerican Journal of Health Promotion, 1993
- The Effects of Behavioral Risks on Absenteeism and Health-Care Costs in the WorkplaceJournal of Occupational and Environmental Medicine, 1991
- Associations between Health Risk Appraisal Scores and Employee Medical Claims Costs in a Manufacturing CompanyAmerican Journal of Health Promotion, 1991
- A Review and Analysis of the Health and Cost-Effective Outcome Studies of Comprehensive Health Promotion and Disease Prevention ProgramsAmerican Journal of Health Promotion, 1991
- The Relationship between Retrospective Health Insurance Claims and a Health Risk Appraisal-Generated Measure of Health StatusJournal of Occupational and Environmental Medicine, 1989
- Development of a Brief Screening Instrument for Detecting Depressive DisordersMedical Care, 1988
- Neurohormonal interactions and adaptations in congestive heart failure.Circulation, 1988