Evaluation of Absenteeism in Disease Management Participants vs. Nonparticipants in a Municipal Population Over 3 Year Period Público
Sayre, Warren Brooks (2013)
Published
Abstract
Objective: To evaluate the disease management program implemented by the City of Knoxville in terms of its effects on employee biometric and absence outcomes.
Methodology: Administrative and biometric data were collected from 2008-2011 on City of Knoxville employees. Those eligible for disease management self-selected participation, and the two groups were compared statistically in terms of year-to-year changes in biometric measures and in absence hours.
Results: Descriptive analysis revealed statistical differences in the participant and nonparticipant groups at baseline. A difference-in-difference analysis of changes in biometric and absence data showed no statistically significant differences between participants and nonparticipants with the exception of diastolic blood pressure, although that outcome was clinically trivial. The analysis of administrative data showed no statistical reduction in absence when comparing the participant and nonparticipant groups (p = 0.58).
Conclusion: Selection bias, inaccurate data collection, and confounding factors prohibit broader attribution of evaluation findings to the general population. Improved evaluation design, including improved case-control matching to minimize confounding and bias and improved data collection to assure accuracy, would better serve future evaluations of the myHealth Program. Inherent variation in data related to absence, make administrative data analysis less useful. Adding productivity questions to an employee health risk assessment may be a better method to measure absence variation as a primary outcome.
Table of Contents
Table of Contents Abstract Acknowledgements
Chapter 1: Introduction to Study
Introduction SettingTheoretical Framework
Research questions
Purpose and Rationale
Chapter 2: Review of the Literature
Introduction to the Review of Literature
Body of Review of Literature
Chapter 3: Methodology IntroductionPopulation and Sample
Chapter 4: ResultsThe results of the study were obtained through a series of analyses. The tables of supporting data are presented in Appendix D of this Thesis.
Descriptive Analysis
Statistical Analysis
Chapter 5: Conclusions, Implications, and Recommendations
IntroductionSummary of study
Limitations and Delimitations
Implications/Conclusions Recommendations ReferencesAppendix A: Definition of Terms
Appendix B: Literature Review
Appendix C: Theoretical Framework
Appendix D: Supporting Data
Table 1. Comparison of Variables of Participants vs. Nonparticipants, Year 0
Table 2. Biometric Comparison of Nonparticipants vs. Participants, Year Zero (2008)
Table 3. Claims-driven Disease Burden for Participants vs. Nonparticipants
Table 4. Comparison of Continuous Variables by Subgroup
Table 5. Statistical Change in Biometrics Year-Over-Year for Nonparticipants and Participants
Table 6. Difference in Difference Biometric Analysis Compared to Year 0 (2008)
Table 7. Mean Changes in Cholesterol Comparing Intervention Years to Year 0
Table 8. Mean Change in LDL Cholesterol by Work Group
Table 9. Mean Difference in Sick Leave by Work Group Compared to Year 0
About this Master's Thesis
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