Indirect cost of ischemic heart disease to employers

Background: The management of healthcare programs by employers requires acc urate information about the indirect and direct costs of important chronic diseases. Objective: To determine the indirect costs of ischemic hear? disease from t he perspective of the employer in private industry in the United States. Design: Indirect cost of illness analysis using the human capital approach, taking the perspective of the employer rather than that of society. Methods: Ischemic heart disease was identified in a proprietary claims data base of 3.1 million insured persons using an algorithm based on administrat ive codes. Economic data were derived from the Bureau of Labor Statistics, the Employment Management Association, and published sources. Work-loss dat a were taken from the National Center for Health Statistics' Health intervi ew Survey. The indirect cost was calculated as the sum of the costs due to morbidity and mortality. From the perspective of the employer, morbidity co sts come from lost productivity, idle assets, and nonwage factors resulting from absenteeism and mortality costs are expenditures for replacing and re training workers. This differs from calculations from the societal perspect ive, in which indirect costs are the value of an individual's lost income-b oth current and potential. Results: The total indirect cost of ischemic heart disease to employers in private industry was $182.74 per enrollee. Ninety-five percent of the indir ect cost was the consequence of work loss due to morbidity rather than of m ortality costs. Conclusion: From the perspective of the employer, the indirect cost of isch emic heart disease is overwhelmingly due to morbidity costs.