Managed care outlook. Employer health costs rise only 3% for 1997.
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Employers' health care costs may be exceeded by their legal costs if they overreact to AIDS in the workplace. A good antidote to the fear and misinformation that leads to such reactions is knowledge of laws relevant to employees with AIDS, as well as to their worried coworkers. A Los Angeles-based attorney who has been very busy advising corporate and health care employers on these matters shares his expertise here.
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Health care insurance claims were used to track costs associated with hypertension for an employed population. Employees were classified as hypertensive (n = 373), high normal (n = 363), or normotensive (n = 2,411) on the basis of hypertension screening done at the worksite. Claims activity was monitored for the three groups during a three-year period, including periods before, during, and after the screening done at the worksite. The average amount claimed per employee was significantly higher for the hypertensives as compared with the normotensives or high normals, even after adjustment for age, race, sex, salary, marital status, and duration of insurance coverage. There was no significant difference in the average amount claimed per employee between high normals and normotensives. The health care costs for hypertensives are estimated to be about 80% more than those for normotensives. Hospital, physicians, and nursing care accounts for about 50 percentage points of this increment while the remaining 30 percentage points derive from drug costs.
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In the Netherlands there is a strict separation between the attending physician, i.e. the general practitioner, and the occupational physician. However, they are supposed to cooperate so that sick-listed patients will return to work earlier. It has now been demonstrated that this cooperation is far from sufficient and that all the expended effort has not led to an increase in patient satisfaction. It has to be admitted that the cooperation has failed. There is a strong need for adherence to guidelines, for quality audits and for scientific investigation in this sector.
BACKGROUND: This study estimates the annual cost of alcohol-related injuries to employers in 1998-2000. METHODS: Incidence was estimated with occupational injury data, motor vehicle crash data and health care data for 1998-2000. Employer costs were estimated from federal estimates of injury costs by source of payment using data on the percentage of varied payment streams (e.g., health insurance, sick leave) paid by employers. RESULTS: The annual employer cost of alcohol-related injuries to employees and their dependents exceed US dollars 28.6 billion. Out of this, US dollars 13.2 billion comes from job-related, alcohol-involved injuries. The annual employer cost of motor vehicle crashes in which at least one driver was alcohol-impaired is over US dollars 9.2 billion. Out of this, only US dollars 3.4 billion comes from job-related alcohol involvement. CONCLUSION: Safety programs can reduce the fringe benefit bill without reducing the benefits offered to employees.
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