Health-related employer support, recurring pain, and direct insurance costs for a self-insured employer.
BACKGROUND
Poor psychosocial workplace factors have been found to cause or exacerbate a variety of health problems, including pain. However, little work has focused on how psychosocial workplace factors, such as health-related employer support, relate to future medical expenditures after controlling for health. Health-related support has also not been well explored in previous literature as a psychosocial factor. This study estimated the association of health-related employer support and pain with future medical expenditures, after including many additional controls.


METHODS
This study used a restricted data set comprised of medical claims and survey data for one company in the U.S. Participants were included in the sample if they had worked for their employer for at least 12 months prior to the survey and if they were continuously eligible for health insurance (N=1,570). Future medical expenditures were measured using administrative claims data covering inpatient, outpatient, mental health and pharmaceutical insurance claims during a year. Health-related employer support was measured using participants' answers about whether the employer would support their efforts to positively change their emotional or physical health. Pain was measured as recurring pain from any condition over the previous year.


RESULTS
Having any physical health-related employer support was associated with a 0.06 increase in the probability of having future medical expenditures greater than zero, 95% CI [0.01, 0.11], but not with total expenditures. Having pain was associated with a 0.06 increase, 95% CI [0.04, 0.09], in the probability of having future medical expenditures greater than zero and with $3,027 additional total expenditures, 95% CI [$1,077, $4,987].


CONCLUSIONS
After controlling for health and pain, psychosocial workplace factors were not robustly associated with future medical expenditures. Pain was associated with increased medical expenditures for the self-insured employer in this study, adjusting for a variety of factors.
Department of Health Policy and Management, UCLA Fielding School of Public Health; (current) Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, 9 Bow Street, Cambridge, MA, 02138, USA. jwilliams@hsph.harvard.edu.
Jessica A R
JA
Williams
D000293:Adolescent; D000328:Adult; D004644:Emotions; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000191:economics* / Q000523:psychology*; D014481:United States; D017132:Workplace / Q000191:economics* / Q000523:psychology*; D055815:Young Adult