The economic value of healthy workers

Objective 1) To demonstrate the feasibility of a designed intervention in changing targeted health behaviors and 2) to evaluate the impact of changes in health risks on the two measures of job performance (a self-reported measure of health-related work impairment (presenteeism) and an objective measure of illness absenteeism). Design A pre/post study design (2004-2005) utilizing Health Risk Appraisal (HRA) data to assess changes in prevalence of individual health risks and changes in two productivity measures. Setting and Subjects Employees of a private insurance provider in Australia. Measures An HRA questionnaire was used to evaluate self-reported work impairment on different aspects of job demands and to assess the prevalence of health risks during March 2004 with a follow-up assessment December 2005. Absence hours due to illness (illness absenteeism) were obtained from company administrative records. Results The most improved health risks associated with the on-site lifestyle program interventions were increased physical activity, better perception of physical health and reduction in smoking although some health risks increased during the time period (e.g., job dissatisfaction and high stress). Changes in percentages of work impairment were significantly associated with changes in numbers of health risks—as health risks decreased, work impairment decreased; as health risks increased, work impairment increased. On average, each risk factor increased or reduced over time was associated with an incremental change of 4.2 percentage points of work impairment. Although there was a trend for changes in illness absenteeism to follow changes in health risks, the differences were not statistically significant. Conclusions This study demonstrates 1) the impact of a designed intervention program on changing health behaviors and 2) preliminary results indicating that changes in productivity measures follow changes in health risks. The study provides a first indication of the potential benefits of health promotion programming to Australian employees in improving health and to the corporation in minimizing health-related productivity loss

Costs and Benefits of Prevention and Disease Management

Prevention and long term disease management have been added relatively recently as `new' components of a modern day total healthcare services system. The goal of primary prevention, which includes medical preventive services, lifestyle interventions and screening services, is to maintain a symptom- and disease-free population. Disease management is a systematic post-disease attempt to manage the consequences of a disease. This article focuses on the costs and savings of prevention and treatment for 7 major diseases which accounted for nearly 80% of the deaths in the US in 1990: heart disease, cancer, diabetes, arthritis, chronic bronchitis, influenza and asthma. The potential impact of prevention and disease management on costs, including productivity, represents a significant return-on-investment to society. Differences in the allocation of direct resources, however, make it nearly impossible to find a single suitable cost measure for the relative cost-effectiveness comparisons of prevention, acute treatment of disease and long term disease management. The relevant question may not be so much the relative cost effectiveness or benefits of the components of healthcare, but the benefits that an integrated approach brings to a total healthcare delivery system.Reviews-on-treatment, Pharmacoeconomics, Disease-management-programmes, Cost-analysis, Coronary-disorders, Cancer, Cancer, Diabetes-mellitus, Rheumatoid-arthritis, Chronic-bronchitis, Influenza-virus-infections, Asthma

Overview of Disease Management Approaches: Implications for Corporate-Sponsored Programs

Corporations have engaged in sponsorship of health management programs and, more recently, disease management programs to facilitate healthy and productive work environments. The purpose of this review is to examine the health and financial outcomes from these corporate-sponsored disease management programs. This article focuses on seven diseases or chronic conditions (arthritis, asthma, cancer, depression, diabetes mellitus, heart disease, and migraine) that potentially impact employee productivity (both in time away from work and in loss of effectiveness at work) and health status including medical and pharmaceutical utilization and costs. Corporate-sponsored disease management programs typically focus on education and screening for selected diseases or chronic conditions. Partnerships have been formed with health plans and third-party program providers to reach employees with interventions and treatment. The typical outcome measures from these programs have primarily been clinical indicators and medical utilization. Measures of productivity need to be incorporated as important outcome measures for disease management programs. The estimated financial opportunity for the corporation is a reflection of the cost differential for a given disease and the prevalence of that disease within the employee population. Primary diseases, chronic conditions, and health risks contribute to increased medical utilization and decreased productivity within the corporation. Promoting programs that focus on the whole person, including health risks, chronic conditions, and diseases, will likely increase the possibility of success in helping the employee to better self-manage their health conditions and consequently provide gains for both the individual and the corporation.Arthritis, Arthritis, Asthma, Asthma, Cancer, Cancer, Depression, Depression, Diabetes-mellitus, Health-economics, Health-education, Diabetes-mellitus, Heart-disorders, Heart-disorders, Migraine, Migraine

Design and Implementation of an Interactive Website to Support Long-Term Maintenance of Weight Loss

Reviewer: Sherwood, NancyReviewer: Wright, JulieReviewer: Bensley, Robert[This item is a preserved copy and is not necessarily the most recent version. To view the current item, visit http://www.jmir.org/2008/1/e1/ ] Background: For most individuals, long-term maintenance of weight loss requires long-term, supportive intervention. Internet-based weight loss maintenance programs offer considerable potential for meeting this need. Careful design processes are required to maximize adherence and minimize attrition. Objective: This paper describes the development, implementation and use of a Web-based intervention program designed to help those who have recently lost weight sustain their weight loss over 1 year. Methods: The weight loss maintenance website was developed over a 1-year period by an interdisciplinary team of public health researchers, behavior change intervention experts, applications developers, and interface designers. Key interactive features of the final site include social support, self-monitoring, written guidelines for diet and physical activity, links to appropriate websites, supportive tools for behavior change, check-in accountability, tailored reinforcement messages, and problem solving and relapse prevention training. The weight loss maintenance program included a reminder system (automated email and telephone messages) that prompted participants to return to the website if they missed their check-in date. If there was no log-in response to the email and telephone automated prompts, a staff member called the participant. We tracked the proportion of participants with at least one log-in per month, and analyzed log-ins as a result of automated prompts. Results: The mean age of the 348 participants enrolled in an ongoing randomized trial and assigned to use the website was 56 years; 63% were female, and 38% were African American. While weight loss data will not be available until mid-2008, website use remained high during the first year with over 80% of the participants still using the website during month 12. During the first 52 weeks, participants averaged 35 weeks with at least one log-in. Email and telephone prompts appear to be very effective at helping participants sustain ongoing website use. Conclusions: Developing interactive websites is expensive, complex, and time consuming. We found that extensive paper prototyping well in advance of programming and a versatile product manager who could work with project staff at all levels of detail were essential to keeping the development process efficient. Trial Registration: clinicaltrials.gov NCT0005492