HEALTH RISK INFLUENCE ON MEDICAL-CARE COSTS AND UTILIZATION AMONG 2,898 MUNICIPAL EMPLOYEES

Introduction: Although worksite health promotion programs are credited with stabilizing medical benefits costs, research is needed to charac terize the medical costs of cohorts with selected health risk factors. The purpose of this study was to compare medical cost outcomes in Cit y of Birmingham, Alabama, employees who differ on selected health risk factors. Methods: Health risk appraisal and medical claims cost data were examined in 2,898 employees participating in health screening dur ing 1992 and 1993. Probit analysis was employed to test the null hypot heses that there are no differences in (1) probability of medical serv ice utilization and (2) probability of medical service cost quartile ( high, moderate, and low) between groups characterized by risks. Age, g ender, race, education, marital status, and diabetes were included as covariates in each model examined. In addition, smoking habits was inc luded as a covariate in models involving risk taking behavior and psyc hosocial risk. Results: Significant differences in medical care utiliz ation and costs were found between risk groups based on psychosocial r isk, cardiovascular disease risk, and total risk. No association was f ound between risk-taking behavior and utilization and costs. Conclusio n. Subjects reporting psychosocial, cardiovascular disease, and total risk factors were more likely to use medical services and to be in the high or high/moderate cost categories.