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.

Overall Well-Being as a Predictor of Health Care, Productivity, and Retention Outcomes in a Large Employer

“…First, the significant relationships between overall well-being and follow-up health care costs and utilization confirm previous work that found well-being as a leading indicator of health care outcomes. 12 This finding is particularly noteworthy given the high amount of variance in the distribution of claims …”

“…Health care outcomes such as medical and pharmacy costs and hospital utilization have been linked to overall well-being in prior studies. 12,13 Although much of the prior literature on health care outcomes has focused on the physical health and behavioral risk subdomains of overall well-being, 14,15 other well-being subdomains related to work, social relationships, finances, and one's community are associated with chronic and acute illness. [16][17][18][19] Only 1 study has investigated the relationship between overall well-being and health care outcomes longitudinally, finding well-being to be a significant predictor of future health care costs and utilization, controlling for past outcomes.…”

Health-Related Quality of Life Impact in Employees Participating in a Pharmacist-Run Risk Reduction Program

“…A study published recently demonstrated a positive relationship between an improvement in an employee's feeling of well-being and the effect on health care utilization and costs. 4 Harrison and colleagues found that a statistically significant (p < 0.01) inverse relationship exists between self-reported well-being scores and short-term health care utilization and spending. Employee members of a health care plan (n=2245) were asked to complete a questionnaire that measured well-being on a 100 point scale.…”

“…Employee members of a health care plan (n=2245) were asked to complete a questionnaire that measured well-being on a 100 point scale. 4 When analyzing the health care utilization and spending of these individuals over a 12 month time period, their results showed that for every one point increase on the well-being scale, a 2.2% decrease in hospital admissions was demonstrated. 4 Additionally, every one point increase correlated to a 1.7% decrease in emergency room visits, and respondents were 1.0% less likely to incur any health care costs, in general.…”

“…3 Recently, data have been published to show that a higher level of self-perceived well-being is associated with lower health care utilization and costs in individuals with chronic conditions. 4 This may be particularly important to…”