The association between decreased employability and the frequency and costs of health care consumption

Background: just as in other western countries, rising health care expenditure is an important topic of discussions in the Netherlands. In order to keep health care affordable it is important to develop interventions aimed at reducing the costs of health care. Health care insurers focus increasingly on prevention for the working population. Impro ving and maintaining the work ability is a potential focus point. Pre vious studies focussed mainly on the indirect costs of a decreased work ability such as loss of productivity, sickness absence, and disability. In this study we are looking at the association between work ability, health care consumption and the associated costs. Methods: In 2011 en 2012 questionnaires were used to gather data on work ability and health care consumption among employees of twelve care institutions (n=5210). Work ability was measured with the work ability index (WAI). Logistic and linear regression analyses were used to study the frequency and costs of health care consumption and the association between work ability and health care consumption. The analyses were observed for age, gender and level of education. Results: Statistically significant trends (p<0.05) were found for decreased work ability and an increased chance of a visit to the GP, physiotherapist, medical specialist and psychologist/psychiatrist as well as higher health care expenditures. Employees with a poor work ability had on average €1084.56 higher health care expenditures per year than employees with a excellent work ability. Employees with a good, moderate or poor work ability visited the GP respectively 2.6, 5.4 en 11.5 times more often than employees with a very good work ability. The same trends were observed for visits to physiotherapists, specialists and psychologists/psychiatrists. All underlying dimensions of the work ability index show the same trend in health care consumption. Discussion: The link between work ability, health care consumption and health care costs is not exclusively explained by the dimension 'diseases' but also by the further dimensions of the WAI. A strong association was found between work ability and the frequency and costs of health care consumption. Improving and maintaining the employability of employees can contribute to keeping health care affordable. Care insurers could pay attention in their prevention policies to the specific role of occupational health care and health promotion on the work floor.

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