title: Evaluation of the relationship between individual well-being and future health care utilization and cost.
abstract: Escalating health care expenditures highlight the need to identify modifiable predictors of short-term utilization and cost. Thus, the predictive value of individual well-being scores was explored with respect to 1-year health care expenditures and hospital utilization among 2245 employees and members of a health plan who completed the Well-Being Assessment (WBA). The relationship between well-being scores and hospital admissions, emergency room (ER) visits, and medical and prescription expenditures 12-months post WBA was evaluated using multivariate statistical models controlling for participant characteristics and prior cost and utilization. An inverse relationship existed between well-being scores and all measured outcomes (P≤0.01). For every point increase in well-being on a 100-point scale, respondents were 2.2% less likely to have an admission, 1.7% less likely to have an ER visit, and 1.0% less likely to incur any health care costs. Among those who did incur cost, each point increase in well-being was associated with 1% less cost, and individuals with low well-being scores (≤50) had 2.7 times the median annual expenditure of individuals with high well-being (>75) ($5172 and $1885, respectively). Also, well-being proved lowest among respondents who incurred more than $20,000, and was highest among those who incurred ≤$5000, with median scores of 71.1 and 80.3, respectively. These results indicate that individual well-being is a strong predictor of important near-term health care outcomes. Thus, well-being improvement efforts represent a promising approach to decrease future health care utilization and expenditures.
authors.affiliation: Center for Health Research, Healthways, Inc, Franklin, TN 37067, USA.
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Harrison
authors.forename: James E
authors.initials: JE
authors.lastname: Pope
authors.forename: Carter R
authors.initials: CR
authors.lastname: Coberley
authors.forename: Elizabeth Y
authors.initials: EY
authors.lastname: Rula
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures / Q000639:trends*; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010549:Personal Satisfaction; D014481:United States