Increasing Diabetes Screening in a Primary Care Setting.

Quality Improvement Success Stories are published by the American Diabetes Association in collaboration with the American College of Physicians and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Each article in the series is reviewed and follows a standard format developed by the editors of Clinical Diabetes. The following article describes an initiative to increase rates of diabetes screening in a large multisite academic health system in the greater Ann Arbor, MI, area.

Impact of compliance to oral hypoglycemic agents on short-term disability costs in an employer population.

This study evaluated the relationships between compliance with oral hypoglycemic agents and health care/short-term disability costs in a large manufacturing company. The retrospective analysis used an observational cohort drawn from active employees of Ford Motor Company. The study population consisted of 4978 individuals who were continuously eligible for 3 years (between 2001-2007) and who received a prescription for an oral hypoglycemic agent during that time. Medical, pharmacy, and short-term disability claims data were obtained from the University of Michigan Health Management Research Center data warehouse. Pharmacy claims/refill data were used to calculate the proportion of days covered (PDC); an individual was classified as compliant if his/her PDC was ≥80%. Model covariates included age, sex, work type, and Charlson comorbidity scores. The impact of compliance on disability and health care costs was measured by comparing the costs of the compliant with those of the noncompliant during a 1-year follow-up. Among these employees, compliant patients had lower medical, higher pharmacy, and lower short-term disability costs than did the noncompliant. After adjusting for demographics and comorbidity, noncompliance was associated with statistically higher short-term disability costs ($1840 vs. $1161, P<0.0001), longer short-term disability duration, and an increase in short-term disability incidence (21.5% of the noncompliant had a claim compared to 16.0% of the compliant, P<0.0001). These results suggest that medication compliance may be important in curtailing the rise of health care/disability costs in the workplace. Employers concerned with the total costs associated with diabetes should not overlook the impact of compliance on short-term disability.

Association of health risks with the cost of time away from work.

The purpose of this study was to combine absences, short-term disability, and workers' compensation into a sum of the cost of time away from work (TAW) and compare it with health risk status and individual health risks of 6220 hourly workers at Steelcase Inc. The study used 3 years (1998 to 2000) of TAW and health risk appraisal data. Higher TAW costs were associated with illness days, drug/medication use, the individual's lower perception of physical health, job dissatisfaction, high stress, life dissatisfaction, and physical inactivity. More high-risk individuals (80.6%) had a TAW occurrence than medium- (72.8%) and low-risk (61.1%) individuals. High-risk individuals had higher TAW costs than medium- and low-risk individuals. Of the total TAW costs, 36.2% was attributed to the excess risks of the medium- and high-risk individuals or nonparticipants compared with low-risk participants. If TAW costs follow risk reduction, a potential annual savings of $1.7 million could be achieved.