title: Favorable Cardiovascular Health Is Associated With Lower Health Care Expenditures and Resource Utilization in a Large US Employee Population: The Baptist Health South Florida Employee Study.
abstract: OBJECTIVE
  To examine the association of favorable cardiovascular health (CVH) status with 1-year health care expenditures and resource utilization in a large health care employee population.
  
  
  METHODS
  Employees of Baptist Health South Florida participated in a health risk assessment from January 1 through September 30, 2014. Information on dietary patterns, physical activity, blood pressure, blood glucose level, total cholesterol level, and smoking were collected. Participants were categorized into CVH profiles using the American Heart Association's ideal CVH construct as optimal (6-7 metrics), moderate (3-5 metrics), and low (0-2 metrics). Two-part econometric models were used to analyze health care expenditures.
  
  
  RESULTS
  Of 9097 participants (mean ± SD age, 42.7±12.1 years), 1054 (11.6%) had optimal, 6945 (76.3%) had moderate, and 1098 (12.1%) had low CVH profiles. The mean annual health care expenditures among those with a low CVH profile was $10,104 (95% CI, $8633-$11,576) compared with $5824 (95% CI, $5485-$6164) and $4282 (95% CI, $3639-$4926) in employees with moderate and optimal CVH profiles, respectively. In adjusted analyses, persons with optimal and moderate CVH had a $2021 (95% CI, -$3241 to -$801) and $940 (95% CI, -$1560 to $80) lower mean expenditure, respectively, than those with low CVH. This trend remained even after adjusting for demographic characteristics and comorbid conditions as well as across all demographic subgroups. Similarly, health care resource utilization was significantly lower in those with optimal CVH profiles compared with those with moderate or low CVH profiles.
  
  
  CONCLUSIONS
  Favorable CVH profile is associated with significantly lower total medical expenditures and health care utilization in a large, young, ethnically diverse, and fully insured employee population.
authors.affiliation: Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL.
authors.forename: Chukwuemeka U
authors.initials: CU
authors.lastname: Osondu
authors.affiliation: Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL; Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, FL.
authors.forename: Ehimen C
authors.initials: EC
authors.lastname: Aneni
authors.affiliation: Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL; Cátedra de Cardiología y Medicina Vascular, Tecnológico de Monterrey, Nuevo León, Mexico.
authors.forename: Javier
authors.initials: J
authors.lastname: Valero-Elizondo
authors.affiliation: Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Salami
authors.affiliation: Wellness Advantage Administration, Baptist Health South Florida, Miami, FL.
authors.forename: Maribeth
authors.initials: M
authors.lastname: Rouseff
authors.affiliation: Wellness Advantage Administration, Baptist Health South Florida, Miami, FL.
authors.forename: Sankalp
authors.initials: S
authors.lastname: Das
authors.affiliation: Wellness Advantage Administration, Baptist Health South Florida, Miami, FL.
authors.forename: Henry
authors.initials: H
authors.lastname: Guzman
authors.affiliation: Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL.
authors.forename: Adnan
authors.initials: A
authors.lastname: Younus
authors.affiliation: Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL.
authors.forename: Oluseye
authors.initials: O
authors.lastname: Ogunmoroti
authors.affiliation: Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL; Department of Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL.
authors.forename: Theodore
authors.initials: T
authors.lastname: Feldman
authors.affiliation: Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL; Department of Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL.
authors.forename: Arthur S
authors.initials: AS
authors.lastname: Agatston
authors.affiliation: Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL; Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, Miami, FL.
authors.forename: Emir
authors.initials: E
authors.lastname: Veledar
authors.affiliation: Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, FL.
authors.forename: Barry
authors.initials: B
authors.lastname: Katzen
authors.affiliation: American Heart Association, Dallas, TX.
authors.forename: Chris
authors.initials: C
authors.lastname: Calitz
authors.affiliation: American Heart Association, Dallas, TX.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Sanchez
authors.affiliation: Department of Preventive Medicine and Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors.forename: Donald M
authors.initials: DM
authors.lastname: Lloyd-Jones
authors.affiliation: Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL; Wellness Advantage Administration, Baptist Health South Florida, Miami, FL; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL; Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, Miami, FL; The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD. Electronic address: khurramn@baptisthealth.net.
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir