Evaluation of Absenteeism in Disease Management Participants vs. Nonparticipants in a Municipal Population Over 3 Year Period Open Access

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 Setting

Theoretical 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 Introduction

Population and Sample

Chapter 4: Results

The 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

Introduction

Summary of study

Limitations and Delimitations

Implications/Conclusions Recommendations References

Appendix 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

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Career Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Health Care Management
Keyword	absenteeism population health disease management
Committee Chair / Thesis Advisor	Goetzel, Ron, Emory University
Committee Members	Brown, Kathleen, Knox County Health Department
Partnering Agencies	Does not apply (no collaborating organization)

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