Rz. Goetzel et al., THE RELATIONSHIP BETWEEN MODIFIABLE HEALTH RISKS AND HEALTH-CARE EXPENDITURES - AN ANALYSIS OF THE MULTI-EMPLOYER HERO HEALTH RISK AND COSTDATABASE, Journal of occupational and environmental medicine, 40(10), 1998, pp. 843-854
This investigation estimates the impact of ten modifiable health risk
behaviors and measures and their impact on health care expenditures, c
ontrolling for other measured risk and demographic factors. Retrospect
ive two-stage multivariate analyses, including logistic and linear reg
ression models, were used to follow up 46,026 employees from six large
health care purchasers for up to 3 years after they completed an init
ial health risk appraisal. These participants contributed 113,963 pers
on-years of experience. Results show that employees at high risk for p
oor health outcomes had significantly higher expenditures than did sub
jects at lower risk in seven often 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 bo
dy weight (21 %), former (20 %) and current (14 %) tobacco users, with
high blood pressure (12 %), and with sedentary lifestyle (10 %). Thes
e same risk factors were found to be associated with a higher likeliho
od of having extremely high (outlier) expenditures, Employees with mul
tiple risk profiles for specific disease outcomes had higher expenditu
res 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 provid
e more precise estimates of the incremental medical expenditures assoc
iated with common modifiable risk factors after we controlled for mult
iple risk conditions and demographic confounders, The authors conclude
that common modifiable health risks are associated with short-term in
creases in the likelihood of incurring health expenditures and in the
magnitude of those expenditures.