Functional Medicine Care was Associated with Lower Pharmacy Claims Costs Among Ashland School District Employee Health Plan Participants With Musculoskeletal Disorders.

IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE
Christopher R D'Adamo, Kelly Grebinsky, Gregory Roedersheimer, Kathi Bowen-Jones, Elyse Wagner, Serena Robinson, David Jones
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引用次数: 0

Abstract

Background: Musculoskeletal disorders are a leading cause of healthcare utilization and disability among the millions of school employees in the United States. While school-based workplace wellness programs have demonstrated improvements in health behaviors, the long-term financial impact of these programs remains unclear.

Objective: Identify factors associated with health insurance claims costs within a school district featuring a workplace wellness program emphasizing health behaviors aligned with the functional medicine model of care.

Setting: Ashland School District in Oregon, USA.

Participants: Ashland School District employee health plan participants.

Methods: Medical and pharmacy claims from 2010 to 2021 were included for analysis. Multivariate linear regression models of medical and pharmacy claims costs were constructed including year of claim, age, sex, baseline comorbidities, and whether the participant received functional medicine care.

Results: The sample included 1,178 participants with musculoskeletal disorders and a total of 92,922 claims. Older age ($46.28 per year, P < .0001) and comorbidities ($258.24 per comorbidity, P = .03) were associated with higher yearly per member medical claims. Older age ($21.84 per year, P < .0001) and comorbidities ($335.62 per comorbidity, P < .0001) were also associated with higher yearly per member pharmacy claims. Receiving functional medicine care (-$534.81, P = .0002) was associated with lower yearly per member pharmacy claims. There were no meaningful changes in total medical or pharmacy claims costs over time after adjustment for covariates (P > .4).

Conclusion: Medical and pharmacy claims remained stable over the study period among employee health plan participants with musculoskeletal disorders, and functional medicine care was associated with significantly lower pharmacy claims costs.

功能医学护理与阿什兰学区员工健康计划中患有肌肉骨骼疾病的参与者降低药房理赔费用有关。
背景:肌肉骨骼疾病是导致美国数百万在校学生使用医疗服务和致残的主要原因。虽然以学校为基础的工作场所健康计划已经证明了健康行为的改善,但这些计划的长期财务影响仍不明确:目的:在一个以工作场所健康计划为特色的校区内,确定与健康保险索赔成本相关的因素,该计划强调与功能医学护理模式相一致的健康行为:美国俄勒冈州阿什兰学区:阿什兰学区员工健康计划参与者:方法:纳入 2010 年至 2021 年的医疗和药费报销单进行分析。建立了医疗和药房报销费用的多变量线性回归模型,其中包括报销年份、年龄、性别、基线合并症以及参保者是否接受了功能医学治疗:样本包括 1,178 名患有肌肉骨骼疾病的参保者和 92,922 份理赔申请。年龄越大(每年 46.28 美元,P < .0001)、合并症越多(每种合并症 258.24 美元,P = .03),每位成员每年的医疗费用报销额就越高。年龄较大(每年 21.84 美元,P < .0001)和合并症(每种合并症 335.62 美元,P < .0001)也与每位会员每年较高的药费索赔有关。接受功能医学治疗(-534.81 美元,P = .0002)与每位会员每年较低的药费报销额度有关。在对共变量进行调整后,医疗或药房索赔总费用没有发生有意义的变化(P > .4):结论:在研究期间,患有肌肉骨骼疾病的员工健康计划参与者的医疗和药费报销费用保持稳定,而功能医学护理与药费报销费用的显著降低有关。
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来源期刊
Alternative therapies in health and medicine
Alternative therapies in health and medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-
CiteScore
0.90
自引率
0.00%
发文量
219
期刊介绍: Launched in 1995, Alternative Therapies in Health and Medicine has a mission to promote the art and science of integrative medicine and a responsibility to improve public health. We strive to maintain the highest standards of ethical medical journalism independent of special interests that is timely, accurate, and a pleasure to read. We publish original, peer-reviewed scientific articles that provide health care providers with continuing education to promote health, prevent illness, and treat disease. Alternative Therapies in Health and Medicine was the first journal in this field to be indexed in the National Library of Medicine. In 2006, 2007, and 2008, ATHM had the highest impact factor ranking of any independently published peer-reviewed CAM journal in the United States—meaning that its research articles were cited more frequently than any other journal’s in the field. Alternative Therapies in Health and Medicine does not endorse any particular system or method but promotes the evaluation and appropriate use of all effective therapeutic approaches. Each issue contains a variety of disciplined inquiry methods, from case reports to original scientific research to systematic reviews. The editors encourage the integration of evidence-based emerging therapies with conventional medical practices by licensed health care providers in a way that promotes a comprehensive approach to health care that is focused on wellness, prevention, and healing. Alternative Therapies in Health and Medicine hopes to inform all licensed health care practitioners about developments in fields other than their own and to foster an ongoing debate about the scientific, clinical, historical, legal, political, and cultural issues that affect all of health care.
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