Do Employees From Less-Healthy Communities Use More Care and Cost More? Seeking to Establish a Business Case for Investment in Community Health

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.

Design and Implementation of Scientific Management and Engineering Intelligence Based on Multivariate Analysis

“…Identify the list of risk factors by presenting potential risks in the project. Sequential speaking: each speech is recorded, and the speech is repeated until all possible risk factors have been considered; open talk: all group members do not need to be in order and speak freely [14]. The flowchart of the brainstorming method is shown in Figure 4 The team members divided the main risks of intelligent engineering projects into five categories based on past experience, namely, market risk, technical risk, design risk, management risk, and contract risk, and constructed a twodimensional matrix with the minimum task module decomposed by WBS and the brainstorming team.…”

Health Systems Approaches to Preventing Chronic Disease: New Partners, New Tools, and New Strategies

“…The evaluation methods reported are striking for the predominance of mixed methods; the use of diverse data sources, including commercial health claims data sets (15,16), electronic health records (4), geotags (16), and new measures such as Facebook click-through rates (13); the use of well-established frameworks such as RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) (4); and for their high level of sophistication (10). Although it is possible to use simple evaluation methods when assessing the value of single components of a larger program (such as the comparative value of different social media methods [13]), evaluation of large, complex programs requires considerable expertise, planning time, and funding.…”

“…Rates of use of preventive services remain low, requiring continuing experiments to find what works in what setting (19) as well as what issues (such as cost to participants) must be considered in planning (15). Expanding partnerships to include businesses, elected officials, and other actors can help reframe perspectives on cost and benefit, as stakeholders learn that the health of the communities is of value far beyond costs and outcomes of health care (16).…”