Developing alternative methods for determining the incidence, prevalence, and cost burden of coronary heart disease in a corporate population.

OBJECTIVE: To determine the most appropriate methods for estimating the prevalence and incidence of coronary heart disease (CHD), the associated risk factors, and health care costs in a corporate setting. METHODS: Using medical insurance claims data for the period of 2005-2009 from 18 companies in the Thomson Reuters MarketScan reg database, we evaluated three alternative methods. RESULTS: Prevalence of CHD ranged from 2.1% to 4.0% using a method requiring a second confirmatory claim. Annual incidence of CHD ranged from 1.0% to 1.6% using a method requiring 320 days of benefits enrollment in the previous year, and one claim for a diagnosis of CHD. CONCLUSION: Alternative methods for determining the epidemiologic and cost burden of CHD using insurance claims data were explored. These methods can inform organizations that want to quantify the health and cost burden of various diseases common among an employed population.

Seven-year trends in employee health habits from a comprehensive workplace health promotion program at Vanderbilt University.

OBJECTIVE: To assess long-term changes in health risks for employees participating in Vanderbilt University's incentive-based worksite wellness program. METHODS: Descriptive longitudinal trends were examined for employees' health risk profiles for the period of 2003 to 2009. RESULTS: The majority of risk factors improved over time with the most consistent change occurring in physical activity. The proportion of employees exercising one or more days per week increased from 72.7% in 2003 to 83.4% in 2009. Positive annual, monotonic changes were also observed in percentage for nonsmokers and seat belt usage. Although the largest improvements occurred between the first two years, improvements continued without significant regression toward baseline. CONCLUSIONS: This 7-year evaluation, with high participation and large sample size, provides robust estimates of health improvements that can be achieved through a voluntary incentive-based wellness program.