THE RELATIONSHIP BETWEEN MODIFIABLE HEALTH RISKS AND HEALTH-CARE EXPENDITURES - AN ANALYSIS OF THE MULTI-EMPLOYER HERO HEALTH RISK AND COSTDATABASE

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.