title: Impact of worksite wellness intervention on cardiac risk factors and one-year health care costs.
abstract: Cardiac rehabilitation and exercise training (CRET) provides health risk intervention in cardiac patients over a relatively short time frame. Worksite health programs offer a unique opportunity for health intervention, but these programs remain underused due to concerns over recouping the costs. We evaluated the clinical efficacy and cost-effectiveness of a 6-month worksite health intervention using staff from CRET. Employees (n = 308) and spouses (n = 31) of a single employer were randomized to active intervention (n = 185) consisting of worksite health education, nutritional counseling, smoking cessation counseling, physical activity promotion, selected physician referral, and other health counseling versus usual care (n = 154). Health risk status was assessed at baseline and after the 6-month intervention program, and total medical claim costs were obtained in all participants during the year before and the year after intervention. Significant improvements were demonstrated in quality-of-life scores (+10%, p = 0.001), behavioral symptoms (depression -33%, anxiety -32%, somatization -33%, and hostility -47%, all p values <0.001), body fat (-9%, p = 0.001), high-density lipoprotein cholesterol (+13%, p = 0.0001), diastolic blood pressure (-2%, p = 0.01), health habits (-60%, p = 0.0001), and total health risk (-25%, p = 0.0001). Of employees categorized as high risk at baseline, 57% were converted to low-risk status. Average employee annual claim costs decreased 48% (p = 0.002) for the 12 months after the intervention, whereas control employees' costs remained unchanged (-16%, p = NS), thus creating a sixfold return on investment. In conclusion, worksite health intervention using CRET staff decreased total health risk and markedly decreased medical claim costs within 12 months.
authors.affiliation: Department of Cardiovascular Disease, Ochsner Health System, New Orleans, Louisiana, USA. rmilani@ochsner.org
authors.forename: Richard V
authors.initials: RV
authors.lastname: Milani
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lavie
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000628:therapy; D001794:Blood Pressure; D050218:Body Fat Distribution; D008076:Cholesterol, HDL / Q000097:blood; D003362:Cost-Benefit Analysis; D003376:Counseling; D003863:Depression / Q000453:epidemiology / Q000628:therapy; D003971:Diastole; D004032:Diet; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006264:Health Benefit Plans, Employee / Q000191:economics*; D017048:Health Care Costs; D006266:Health Education; D006293:Health Promotion; D006304:Health Status; D006791:Hostility; D006801:Humans; D007345:Insurance Claim Review; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009786:Occupational Health Services / Q000191:economics* / Q000458:organization & administration*; D011788:Quality of Life; D012017:Referral and Consultation; D018570:Risk Assessment; D012307:Risk Factors; D016540:Smoking Cessation
chemical_list: D008076:Cholesterol, HDL