Abstract P303: Impact of an Employee Health Promotion Program on Cardiovascular Goal Attainment and Cardiovascular Related Medical and Hospital Claims and Costs

Abstract

CSX Transportation, a national company with 30,000 employees, developed a comprehensive health promotion program to address cardiovascular (CV) disease. High employee CV risk compared to national benchmarks and rising healthcare costs resulted in the need to create the program in 2004. Over time a variety of interventions (ie, biometric screenings, nutrition/exercise health coaching, on-site fitness centers, etc) were implemented at multiple employee locations. An integrated analysis of the impact of the program on goal attainment rates and CV-related medical and hospital claims was completed using 2006 to 2008 data on 5,768 non-union employees. Data integration was completed by linking 3 data sets: biometric results, medical and pharmacy claims. Statistical analysis was completed using Chi Square and Two-Sample T-Tests. In employees with dyslipidemia, mean total cholesterol declined from 196.4 to 185.2 mg/dL (p=0.001), HDL increased from 38.7 to 42.1 mg/dL (p=0.003), and TChol/HDL ratio declined from 5.5 to 4.9 (p<0.001). The percentage of employees reaching LDL goals increased from 48.0% (47/98) to 62.4% (111/178) (p=0.021). In employees with hypertension, mean blood pressure (BP) declined from 137.2/86.1 to 125.4/80.2 mm Hg (p<0.001, for systolic & diastolic). BP goal attainment increased from 42.5% (68/160) to 67.4% (319/473) (p<0.001). In employees with diabetes, mean fasting blood glucose (BG) remained unchanged [129.7 vs 129.6 mg/dL (p=NS)], while non-fasting BG declined from 152.3 to 146.2 mg/dL (p=NS). Analysis of medical claims data for all employees with at least 1 of the 3 conditions revealed reductions in CV-related medical and hospital claims relative to total medical claims. The percentage of employees with a CV-related medical claim declined from 56.6% (1158/2047) to 48.3% (1391/2878) (p<0.001) and CV-related medical claims declined from 14.1% (5479/38770) to 13.1% (6755/51581) (p<0.001). The percentage of employees with a CV-related hospital claim declined from 6.0% (122/2047) to 4.3% (123/2878) (p=0.007) and CV-related hospital claims declined from 2.5% (951/38770) to 1.7% (874/51581) (p<0.001). As a result of the program, CV related medical and hospital costs both declined significantly relative to total medical costs.