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Do Employees From Less-Healthy Communities Use More Care and Cost More? Seeking to Establish a Business Case for Investment in Community Health.
Prev Chronic Dis. 2019 07 25; 16:E95.PC

Abstract

INTRODUCTION

Few studies have examined the impact of community health on employers. We explored whether employed adults and their adult dependents living in less-healthy communities in the greater Philadelphia region used more care and incurred higher costs to employers than employees from healthier communities.

METHODS

We used a multi-employer database to identify adult employees and dependents with continuous employment and mapped them to 31 zip code regions. We calculated community health scores at the regional level, by using metrics similar to the Robert Wood Johnson Foundation (RWJF) County Health Rankings but with local data. We used descriptive analyses and multilevel linear modeling to explore relationships between community health and 3 outcome variables: emergency department (ED) use, hospital use, and paid claims. Business leaders reviewed findings and offered insights on preparedness to invest in community health improvement.

RESULTS

Poorer community health was associated with high use of ED services, after controlling for age and sex. After including a summary measure of racial composition at the zip code region level, the relationship between community health and ED use became nonsignificant. No significant relationships between community health and hospitalizations or paid claims were identified. Business leaders expressed interest in further understanding health needs of communities where their employees live.

CONCLUSION

The health of communities in which adult employees and dependents live was associated with ED use, but similar relationships were not seen for hospitalizations or paid claims. This finding suggests a need for more primary care access. Despite limited quantitative evidence, business leaders expressed interest in guidance on investing in community health improvement.

Authors+Show Affiliations

Jefferson College of Population Health, Philadelphia, Pennsylvania.Jefferson College of Population Health, Philadelphia, Pennsylvania.Gallagher Benefit Services, Princeton, New Jersey.Greater Philadelphia Business Coalition on Health, Philadelphia, Pennsylvania.Jefferson College of Population Health, Philadelphia, Pennsylvania.CFO Alliance, Wayne, Pennsylvania.Public Health Management Corporation, Philadelphia, Pennsylvania.Greater Philadelphia Business Coalition on Health, 123 South Broad St, Suite 1235, Philadelphia, PA 19109. Email: ngoldfarb@gpbch.org.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31344336

Citation

McIntire, Russell K., et al. "Do Employees From Less-Healthy Communities Use More Care and Cost More? Seeking to Establish a Business Case for Investment in Community Health." Preventing Chronic Disease, vol. 16, 2019, pp. E95.
McIntire RK, Romney MC, Alonzo G, et al. Do Employees From Less-Healthy Communities Use More Care and Cost More? Seeking to Establish a Business Case for Investment in Community Health. Prev Chronic Dis. 2019;16:E95.
McIntire, R. K., Romney, M. C., Alonzo, G., Hutt, J., Bartolome, L., Wood, G., Klein, G., & Goldfarb, N. I. (2019). Do Employees From Less-Healthy Communities Use More Care and Cost More? Seeking to Establish a Business Case for Investment in Community Health. Preventing Chronic Disease, 16, E95. https://doi.org/10.5888/pcd16.180631
McIntire RK, et al. Do Employees From Less-Healthy Communities Use More Care and Cost More? Seeking to Establish a Business Case for Investment in Community Health. Prev Chronic Dis. 2019 07 25;16:E95. PubMed PMID: 31344336.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Do Employees From Less-Healthy Communities Use More Care and Cost More? Seeking to Establish a Business Case for Investment in Community Health. AU - McIntire,Russell K, AU - Romney,Martha C, AU - Alonzo,Greg, AU - Hutt,Jill, AU - Bartolome,Lauren, AU - Wood,Greg, AU - Klein,Gary, AU - Goldfarb,Neil I, Y1 - 2019/07/25/ PY - 2019/7/26/entrez PY - 2019/7/26/pubmed PY - 2020/4/30/medline SP - E95 EP - E95 JF - Preventing chronic disease JO - Prev Chronic Dis VL - 16 N2 - INTRODUCTION: Few studies have examined the impact of community health on employers. We explored whether employed adults and their adult dependents living in less-healthy communities in the greater Philadelphia region used more care and incurred higher costs to employers than employees from healthier communities. METHODS: We used a multi-employer database to identify adult employees and dependents with continuous employment and mapped them to 31 zip code regions. We calculated community health scores at the regional level, by using metrics similar to the Robert Wood Johnson Foundation (RWJF) County Health Rankings but with local data. We used descriptive analyses and multilevel linear modeling to explore relationships between community health and 3 outcome variables: emergency department (ED) use, hospital use, and paid claims. Business leaders reviewed findings and offered insights on preparedness to invest in community health improvement. RESULTS: Poorer community health was associated with high use of ED services, after controlling for age and sex. After including a summary measure of racial composition at the zip code region level, the relationship between community health and ED use became nonsignificant. No significant relationships between community health and hospitalizations or paid claims were identified. Business leaders expressed interest in further understanding health needs of communities where their employees live. CONCLUSION: The health of communities in which adult employees and dependents live was associated with ED use, but similar relationships were not seen for hospitalizations or paid claims. This finding suggests a need for more primary care access. Despite limited quantitative evidence, business leaders expressed interest in guidance on investing in community health improvement. SN - 1545-1151 UR - https://www.unboundmedicine.com/medline/citation/31344336/Do_Employees_From_Less-Healthy_Communities_Use_More_Care_and_Cost_More_Seeking_to_Establish_a_Business_Case_for_Investment_in_Community_Health L2 - https://www.cdc.gov/pcd/issues/2019/18_0631.htm DB - PRIME DP - Unbound Medicine ER -