Differences in Health Care Costs and Utilization among Adults with Selected Lifestyle-Related Risk Factors

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Abstract
Purpose.: This study examined the relationship between lifestyle-related health risks and health care costs and utilization in adults. Design.: A 2-year prospective study with no intervention was used to compare health care utilization and costs in employees with different levels of health risks. Setting.: Data were collected at a primarily white-collar worksite during 1994 and 1995. Subjects.: Subjects included 982 employees and spouses, mean age 32.1 ± 10.1 years. Measures.: Employee medical claims obtained from a third-party administrator were analyzed with respect to health care expenses and utilization. Exercise habits, stress, and overall wellness were assessed by self-report and obesity by the body mass index (BMI). Regression, regression with outliers removed, and odds ratios were used to analyze the associations. Results.: Employees who were at high risk for overall wellness (2.4 times), stress (1.9 times), and obesity (1.7 times) were more likely to have high health care costs (>$5,000) than subjects not at high risk. Mean total medical costs also were greater for high-risk subjects compared to lower risk subjects for overall wellness (difference = $1,973; F = 10.65, p = .001), stress (difference = $1,137; F = 7.35, p = .007), and obesity (difference = $1,092; F = 9.09, p = .003). The exercise habits measure was not significantly associated with health care costs or utilization. Conclusions.: Results indicate that health risks, particularly obesity, stress, and general lifestyle, are significant predictors of health care costs and utilization in employed young adults.