TY - JOUR
T1 - Analysis of a corporation’s health care experience
T2 - Implications for cost containment and disease prevention
AU - Bemacki, Edward J.
AU - Tsai, Shan P.
AU - Miller Reedy, Susan
PY - 1986/7
Y1 - 1986/7
N2 - This article presents the health care experience of 14,162 employees and their families, covered under a private third- party insurance plan of a large multinational corporation for the 1984 policy year. A total of $29.5 million was charged by health care providers to deliver medical care for the studied employees and their families. This amounted to $2,083 per employee and his/her family. Approximately 51% of the employees submitted claims, with females having greater utilization than males. The highest expenditures were for diseases of the circulatory system among adults (3.2 million or 23% for employees, $1.5 million or 14% for spouses). Among employees, neoplasms accounted for $1.4 million or 10% of costs, and musculoskeletal system $1.2 million or 9% of costs. Among spouses, pregnancy and diseases of the female reproductive system accounted for $1.2 million (12%) and $1.1 million (10%), respectively. Among dependents, the top three cost categories were mental disorders ($1.2 million or 24%), accident-related illnesses ($0.7 million or 14%), and diseases of the respiratory system ($0.6 million or 12%). Hospital care expenditures, including room and board, ancillary, and physician services, accounted for approximately 60% of total health care spending. The percentage of health care costs paid for by this insurance plan was 75% for active employees, 34% for retirees, 60% for female spouses, 38% for male spouses, and 64% for dependents. The analyses and parameters measured can be viewed as the first step toward the development of a health care cost containment and disease prevention strategy.
AB - This article presents the health care experience of 14,162 employees and their families, covered under a private third- party insurance plan of a large multinational corporation for the 1984 policy year. A total of $29.5 million was charged by health care providers to deliver medical care for the studied employees and their families. This amounted to $2,083 per employee and his/her family. Approximately 51% of the employees submitted claims, with females having greater utilization than males. The highest expenditures were for diseases of the circulatory system among adults (3.2 million or 23% for employees, $1.5 million or 14% for spouses). Among employees, neoplasms accounted for $1.4 million or 10% of costs, and musculoskeletal system $1.2 million or 9% of costs. Among spouses, pregnancy and diseases of the female reproductive system accounted for $1.2 million (12%) and $1.1 million (10%), respectively. Among dependents, the top three cost categories were mental disorders ($1.2 million or 24%), accident-related illnesses ($0.7 million or 14%), and diseases of the respiratory system ($0.6 million or 12%). Hospital care expenditures, including room and board, ancillary, and physician services, accounted for approximately 60% of total health care spending. The percentage of health care costs paid for by this insurance plan was 75% for active employees, 34% for retirees, 60% for female spouses, 38% for male spouses, and 64% for dependents. The analyses and parameters measured can be viewed as the first step toward the development of a health care cost containment and disease prevention strategy.
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U2 - 10.1097/00043764-198607000-00010
DO - 10.1097/00043764-198607000-00010
M3 - Article
C2 - 3734919
AN - SCOPUS:0022527144
SN - 1076-2752
VL - 28
SP - 502
EP - 508
JO - Journal of Occupational and Environmental Medicine
JF - Journal of Occupational and Environmental Medicine
IS - 7
ER -