Identifying families at high risk of cardiovascular disease: alternative work site approaches.
By examining coverage, concordance, and costs, this project evaluated four methods of cardiovascular disease (CVD) risk screening at a work site with 1821 central office employees of an energy company in Houston, Tex. Screening methods included a health risk appraisal mail questionnaire (HRA), an HRA plus brief physical assessment, an analysis of medical claims data, and an analysis of absenteeism data. Coverage ranged from 99% of employees for the absenteeism method to about 30% for the HRA method. Combining the first three screening methods, 18% of families had at least one member with a CVD or related diagnosis or one of four major CVD risk factors. The absenteeism method yielded 12.1% of the central office employees with 9 or more days absent. Although the absenteeism method identified high-cost families, only 9% had a heart disease or related diagnosis. This lack of concordance also occurs with other methods. For example, only 9.4% of families identified with the claims data were also identified by the HRA. Therefore, the methods identify different groups of high-risk families. Findings are discussed in relation to costs and other factors important to firms' selection of screening methods.
Lairson
D R
DR
University of Texas Health Science Center, School of Public Health, Houston 77225.
Herd
J A
JA
Mullen
P D
PD
Aday
L A
LA
Yang
M C
MC
D000041:Absenteeism; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D003365:Costs and Cost Analysis; D005190:Family; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D009787:Occupational Medicine; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires