A Control Data Corporation study found the following:
n Overweight individuals
incurred 48% more annual claims over $5,000.
n Smokers filed 29% more annual
claims over $5,000.
n People with high blood pressure
incurred 25% more claims over $5000.
n Individuals with high cholesterol
levels filed 24% more claims over $5,000.
n Those who did not use seat belts generated
36% more claims over $5,000.
Some studies suggest Americans are getting healthier. The 1994 Northwestern National Life Insurance State Health Rankings found the national score improved by 2.4% since 1990, due largely to a decline in smoking, motor vehicle accidents and infant mortality, and greater state support for low-income people. Heart disease death rates declined by 25.7% from 1981 to 1991. (The American Heart Association) Yet, in spite of the recent "health craze," Americans are heavier than ever. More than 30% are obese today... that represents an increase of 30% in the prevalence of obesity during the past decade. (Journal of the American Medical Association/ Time, January 16, 1995) And nearly 51% of deaths and disabilities are caused by conditions that can be prevented through changes in behavior. (U.S. Public Health Service)
In this study, the Community Health Audit™ reviews the inpatient and outpatient claims of Evansville Community to answer the following questions:
1 How much of Evansville's health care costs are
attributable to lifestyle related illnesses?
2 How much of that cost could reasonably be saved through health promotion?
3 What health risks are of importance for Evansville?
CHART 2
Risk Categories Studied
n smoking
n obesity
n high cholesterol
n lack of exercise
n stress/mental health
n high blood pressure
n alcohol abuse
n drug abuse
n poor dental care
n poor prenatal care
n STDs
n avoidable accidents
The CHA has determined that 43%, or $178,916,728 of the
Evansville Community's Indiana patients' total health care costs have a
link to lifestyle or behavior.* The CHA does this by comparing your community's
claims to over 1,600 diagnosis codes which have proven relationships with one
or more of the risk factors at right. It is impossible to eliminate all of the
costs associated with these illnesses, because the same conditions can also
occur in people with no risk factors. In other words, while smoking increases
the odds of getting lung cancer, not everyone who gets lung cancer is a smoker.
Some people get sick because of genetics, environment, or simply bad luck. To
successfully determine the portion of your lifestyle/behavior costs that can
be controlled, the CHA uses a series of mathematical formulas, including
calculations for the prevalence of each health risk in the population (the
percentage of males/females who are smokers) and risk ratios which
determine each risk factor's effect on the odds of getting each particular
illness. In this way, we identify the costs that you can impact through health
promotion: your "potential savings."
* 15,808 claim records were found to be missing the ICD-9
code needed to determine their relationship to lifestyle. These claims,
totaling $7,519,476.83, were therefore placed in the "All Other"
claims category and are not considered in the remainder of the report.