employee health screening: step up please!...9/3/2015 dr. azlan t aps2015 1 employee health...
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9/3/2015 1 Dr. Azlan – APS2015
Employee Health Screening:
Step up please!
Dr. Azlan Darus
Manager,
Prevention and Health Promotion Unit
Social Security Organization
9/3/2015 2 Dr. Azlan – APS2015
INVALIDITY PENSION BENEFIT REPORTED FOR NCD CASES
YEAR 2000 - 2014
TOTAL
Invalidity Pension
• Between 35-49% of
claims for Invalidity
Pension benefit
reported were due
to non-
communicable
diseases.
0
500
1,000
1,500
2,000
2,500
3,000
3,500
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Cardiovascular Diabetes Cancer Mental disorders Respiratory
9/3/2015 3 Dr. Azlan – APS2015
TOTAL
SURVIVORS PENSION BENEFIT REPORTED FOR
NCD CASES: YEAR 2000 - 2014
Survivors Pension
• Almost 45% -50% of
claims for Survivors
Pension
• benefit reported
were due to non-
communicable
diseases.
0
500
1,000
1,500
2,000
2,500
3,000
3,500
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Cardiovascular Diabetes Cancer Mental disorders Respiratory
9/3/2015 4 Dr. Azlan – APS2015
The cost of non-communicable
diseases
Malaysia 11.5 16.3 22.5 30.4 40.3
Malaysia 4.6 4.7 4.9 5.0 6.1
9/3/2015 5 Dr. Azlan – APS2015
345.57 340.97
413.39
453.65
496.82
124.40 112.52 140.55
149.70
243.44
-
100
200
300
400
500
600
2010 2011 2012 2013 2014
RM
Mil
lio
ns
Total Payment for Invalidity Benefit and Estimated Total Payment due to NCD,
2008 - 2014
Invalidity Pension Invalidity Pension Due to NCD
Cost of Invalidity Pension Benefit (SOCSO)
9/3/2015 6 Dr. Azlan – APS2015
581.52 583.76
704.29
762.20
834.70
296.58 280.21 345.10
342.99 383.96
-
100
200
300
400
500
600
700
800
900
2010 2011 2012 2013 2014
RM
Mil
lio
ns
Total Payment for Survivors Benefit Pension and Estimated Total Payment
due to NCD, 2008 - 2014
Survivors Pension Survivors Pension Due to NCD
Cost of Survivors Pension Benefit (SOCSO)
9/3/2015 7 Dr. Azlan – APS2015
Health screening
• Intended to reduce morbidity and prolong life
– Possible benefits
• Preventive treatment reducing morbidity and mortality
• Detection of precursors of disease e.g cervical dysplasia
• Detection of sign and symptoms of manifest disease
otherwise not considered important
• Some may improve lifestyle following screening and
counselling
Lasse T Krogsbøll , Karsten Juhl Jørgensen , Christian Grønhøj Larsen, Peter
C Gøtzsche ; BMJ 2012;345:e7191 doi: 10.1136/bmj.e7191
9/3/2015 8 Dr. Azlan – APS2015
General Health Screening
• In the UK, publicly funded NHS check
programme in 2009.
– Full implementation in England in 2013
9/3/2015 9 Dr. Azlan – APS2015
General Health Screening
• In Japan; nationwide health screening programme targeting metabolic syndrome since April 2008.
– Screening and risk based counselling
– Raise public awareness on metabolic diseased and promote better lifestyles
• In S. Korea; national screening program introduced in 1995.
– E ha ed to Natio al “ ree i g Progra for Tra sitio al Ages i 2007
– Target two age groups; 40 and 66 years old
Kohro, Furui, Mitsutake et al. ;
Int Heart J March 2008
Hyun Su Kim, Dong Wook Shin, Won Chul Lee et al. ;
J Korean Med Sci 2012; 27: S70-75
9/3/2015 10 Dr. Azlan – APS2015
General Health Screening
• In Singapore; – Integrated Screening Programme
• nation-wide programme for Singaporeans aged 40 years and older
• screened for diabetes, high blood pressure, high blood cholesterol, obesity and cervical cancer at registered GP clinics.
• Subsidized screening cost; user pays for consultation
• In Malaysia; – Free health screening for government employees age 40 years old at
government health clinics • Since 1969 (managerial and professionals)
• 2003 to include all employees
• Not a dator , ut stro gl e ouraged
– For private employees; • Depends on medical benefit provided by companies
• SOCSO Health Screening Program
9/3/2015 11 Dr. Azlan – APS2015
The SOCSO Health Screening Programme
• Offered to all insured persons by SOCSO at the age 40 years old.
• As a way to provide benefit token to all active employees
• To increase insured persons awareness of non-communicable diseases
• Promote healthy lifestyle and health empowerment via early detection and medical counseling.
9/3/2015 12 Dr. Azlan – APS2015
• Health Screening as
a mean; not the end
– ENABLING
employees in the
country to take
charge of their
health
• By knowing their
own health status
9/3/2015 13 Dr. Azlan – APS2015
USAGE AND TRENDS
9/3/2015 14 Dr. Azlan – APS2015
The SOCSO Health Screening Programme
• Roll out Jan 2013
• 2 100 000 active employees are eligible until
the year 2015
• All eligible employees are invited through
vouchers sent via their employers
9/3/2015 15 Dr. Azlan – APS2015
The SOCSO Health Screening Programme
(27 Jul 2015)
431 227 Employees
underwent the health
screening
145 626 Women used the
mammogram
voucher
3357 Registered clinics
116 Mammogram
centers
248 Laboratories
9/3/2015 16 Dr. Azlan – APS2015
SOCSO HSP - usage
14,803
7,905
7,619
7,130
9,465
12,354
3,231
2,255
2,689
3,492
4,870
9,904
1974
2,530
3,596 4,447
2,662 2,525
1,916
-
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
Jan-14 Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan-15 Feb Mar Apr Mei Jun July
Baucar 2013 Baucar 2014 Baucar 2015 Jumlah
9/3/2015 17 Dr. Azlan – APS2015
Trend of use by state
0
10000
20000
30000
40000
50000
60000
70000
80000
numbers
9/3/2015 18 Dr. Azlan – APS2015
Trend of use by state
0
5
10
15
20
25
30
35
percentage
9/3/2015 19 Dr. Azlan – APS2015
Number of unused vouchers and
employers
154,305
40648
1343 53
# employers
<5
5-100
100-1000
>1000
9/3/2015 20 Dr. Azlan – APS2015
Health seeking behavior
Have Had Previous Health Screening
– 33.3% of employees had a comprehensive health screening
– i.e 66.7% had not had a comprehensive health screening prior to the HSP!
Ethnic distribution Malay : 35.0% Chinese : 46.5% Indian : 12.0% Bumiputera Sabah : 2.5% Bumiputera Sarawak : 3.0% Others : 1.0%
Male
53%
Female
47%
9/3/2015 21 Dr. Azlan – APS2015
BMI status
• Body Mass Index
• Underweight : 3.2%
• Normal : 23.8%
• Pre-Obese : 39.3%
• Obese Class 1 : 28.9%
• Obese Class 2 : 3.6%
• Obese Class 3 : 1.2% • (CPG Mgt Obesity 2004)
Normal
103,352
27%
Overweight
150,663
39%
Obese
129,172
34%
9/3/2015 22 Dr. Azlan – APS2015
Diabetes
• Diabetes Mellitus
(based on venous plasma glucose)
• Normal
: 74.5%
• IFG/IGT
: 16.3%
(further tests required)
• Diabetes :
: 9.3% • (CPG Mgt Type 2 Diabetes Mellitus 2009)
Normal
286,571
75%
Pre-Diabitis
62,605
16%
Diabitis
35,625
9%
9/3/2015 23 Dr. Azlan – APS2015
Hypertension
• ¨ Hypertension
• Optimal : 19.6%
• Normal : 32.7%
• High Normal : 20.5%
• Hypertension Stage 1 : 20.2%
• Hypertension Stage 2 : 5.6%
• Hypertension Stage 3 : 1.4% • (CPG Mgt Hypertension 2013)
Normal
200,908
52%
Pre-
Hypertensio
n
78,867
21%
Hypertensio
n
104,314
27%
9/3/2015 24 Dr. Azlan – APS2015
Cancer screening
• Female Cancer Screening
• Pap Smear (n= 116,004)
• 71.6% found with normal findings.
• 28.0% endometrial cells (others).
• 0.4% with abnormal results.
• - Six (6) were found with carcinoma in situ.
• - 139 with high grade squamous or glandular lesion.
9/3/2015 25 Dr. Azlan – APS2015
• ¨ Mammogram (n= 98,815)
• 65% found with normal findings (category 1).
• 6% need for additional imaging (category 0).
• 28% found with benign findings (category 2 & 3).
• 1% with suspicious and highly suspicious results.
• - 164 with findings highly suggestive of malignancy. • (CPG Mgt Breast Ca 2010)
Cancer screening
9/3/2015 26 Dr. Azlan – APS2015
ISSUES
• Do ’t k ow that su h e efit e ists
• Voucher not received by employers
• Voucher not distributed by employers – Distance / extra task
– Employer have better program
• Employees received voucher – Interested and use
– Interested but not suitable time / procrastinate • Leave issues
• Time off work issues
– Have done it at other times
– Not interested
9/3/2015 27 Dr. Azlan – APS2015
Would these work?
• Employer
– Provide time assistance.
– Integrate into current medical benefit system or medical surveillance system.
• Clinics
– Close work with employer
• Mass workplace screening
• Employees
– Step up and take charge of your own health!
