naaso 2005 power point
TRANSCRIPT
Reduction of Risk Factors for Diabetes and Cardiovascular Disease: Results from a Novel Two-
year, Employee-based Intervention Program. Robert C. Lowe1, Debbie Zimmerman1, Philip Chen2, and Jan Bush3
1Polk County School Board, Winter Haven, Florida; 2Cognoscenti Health Institute, Orlando, Florida; and 3RobinsonBush, Orlando, Florida.
Background
Diabetes and cardiovascular diseases are the two most common chronic diseases with modifiable risk factors. The prevalence of both diseases in our population is higher than the U.S. national averages. The health care costs for these employees, retirees, and dependents are substantially higher than for the balance of the insured.
Purpose
The purpose of the present investigation was to initiate a two-year pilot project with the goal of reducing the health care costs related to diabetes and cardiovascular disease in a group of public school employees.
Methods
Multiple biometric measurements to assess diabetes and cardiovascular disease risks were collected. Baseline measures included body fat percentage, blood pressure, total cholesterol, HDL-C, LDL-C, triglycerides, fasting blood sugar, Insulin Resistance Index, and homocysteine. In addition, physical activity level, family disease history, and smoking history was collected through detailed, one-on-one interviews. All measures were repeated at one year and two years. Based on the results, individuals were prescribed various interventions. Stepwise counseling and referral programs were provided following stratification of risk factors.
Conclusion
A favorable shift in all biometrics occurred at two years with the exception of HDL-C and Homocysteine. Furthermore, the pilot group had average per capita health claims costs $613 and $498 per year lower, respectively, than the remaining employees. This translated to savings of $1,075,202 and $823,692 in year one and year two, respectively. These data suggest that the targeted intervention programs reached their intended goals for most of the modifiable risk factors thus reducing health care costs.
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For further information please contact:Robert Lowe, M.A., FAACVPR
ABCs of Health
Results
Biometric Measures Initial Metric (2002)
# %
Follow-Up Metric (2003)
# %
Follow-Up Metric (2004) # %
Percent Change
Laboratory Testing n=579 n=562 Total Cholesterol >240 200-240 < 200
(84) 14.5% (176) 30.3% (319) 55.1%
(72) 12.4% (171) 29.5% (336) 58.0%
(58) 10.3% (138) 24.6% (366) 65.1%
-28.9% -18.8% +18.1%
Triglycerides >160 <160
(150) 26% (429) 74%
(130) 22% (449) 78%
(129) 23.0% (433) 77.0%
-11.5% +4.1%
LDL Cholesterol >160 130-160 <130
(75) 13.0% (128) 22.1% (376) 64.9%
(64) 11.1% (129) 22.3% (386) 66.7%
(45) 8.0% (97) 17.2% (420) 74.7%
-38.5% -22.2% +15.1%
HDL Cholesterol < 40 > 40
(71) 12.3% (508) 87.7%
(74) 12.8% (505) 87.2%
(98) 17.4% (464) 82.5%
+41.4% -5.9%
Insulin Resistance Index >3.22 2.93-3.22 <2.93
(81) 14.0% (185) 32.0% (313) 54.1%
(90) 15.5% (151) 26.1% (338) 58.4%
(85) 15.1% (145) 25.8% (332) 59.1%
+7.9% -19.4% +9.2%
Homocysteine >12.0 10.0-12.0 <10.0
(47) 8% (74) 13% (458) 79%
(53) 9% (89) 15% (437) 75%
(48) 8.5% (86) 15.3% (428) 76.2%
+6.3% +17.6% -3.6%
Non-Laboratory (ALL participants)
n=1137
n=1142
n=780
Body Fat% M >25%; F >32% M <25%; F <32%
(796) 70% (341) 30%
(754) 66% (388) 34%
(455) 59% (317) 41%
-15.7% +36.7%
High Blood Pressure > 140/90 < 140/90
(262) 23% (875) 77%
(274) 24% (868) 76%
(147) 19% (628) 81%
-17.4% +5.2%
Sedentary Lifestyle (Self reporting*) YES NO
(489) 43% (648) 57%
(251) 22% (891) 78%
(204) 28% (515) 72%
-35% +26%
Smoking (Self Reporting*) YES NO
(102) 9% (1035) 91%
(80) 7% (1062) 93%
(61) 8% (699) 92%
-11%
+1.1%