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More money doesn't mean better care Medicare study; Kaiser Health Poll Report on biggest fears; Mercer and Marsh study on increase in long- and short-term disability incidence



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Medicare patients living in higher-spending regions receive roughly 60 percent more care than those in lower spending regions, but they don't experience better health as a result, says a new study recently published in the Annals of Internal Medicine.

Researchers observed four key groups: patients with heart attacks, hip fracture, colorectal cancer and a general population sample. Those in the higher-spending regions had far more days in the hospital, diagnostic tests and referrals to specialists. But quality of care, long-term survival, functional status and patient satisfaction weren't any better than in lower-spending regions. The report suggests that up to 30 percent of Medicare spending could be eliminated if the more conservative practice patterns were the norm nationwide.

Fifty six percent of employees consider health and wellness programs to be important reasons for sticking with their current job, according to a recent study by the American Association of Occupational Health Nurses Inc. The lower the salary, the greater the impact on employee retention.



Two out of three Americans are worried that their health care costs will rise over the next six months, according to the latest Kaiser Health Poll Report, a concern that's been stoked by numerous polls and projections. Just as many, however, are worried that their income won't be able to keep up with the rising costs over the same time period, even though inflation is low and there's serious talk of deflation.

The report also found that 47 percent worry they won't be able to afford necessary prescription drugs, and 57 percent are worried that the quality of health care services they receive will worsen. Health concerns are far more common than worry about stock market losses, terrorist attacks or potential unemployment.

For details on this Kaiser Report, including charts and graphs, click here.

Nearly half of employees feel less productive in winter months, says a nationwide ComPsych poll looking at Seasonal Affective Disorder. One in three employees have decreased levels of energy in the darker months, compared to one in five with year-round symptoms.



Over a two-year period, long-term disability incidence increased among 26 percent of employers that measured it, and short-term increased for roughly one-third, according to a recent survey by Mercer Human Resource Consulting and Marsh Inc.

Besides various musculoskeletal conditions, obesity may play a role. "We've seen tremendous evidence now of both the impact of obesity on the incidence of diabetes, and the secondary relationship of diabetes to heart disease," William Craig, MD, an absence management expert at Marsh, told Business & Health. Job uncertainty and terrorist threats are also potential contributors because "those kinds of psychological things don't just manifest as stress and depression. They often manifest as back pain, neck pain and other kinds of musculoskeletal problems."

The majority of employers cited increased disability due to stress or depression, cancer, low back pain, upper extremity repetitive trauma and other musculoskeletal issues.

Time-off and disability programs accounted for an average 15 percent of payroll in 2001, up from 14.6 percent in 2000. Unscheduled absences rose to 4.7 percent in 2001, up from 4.4 percent in 2000.

Another key finding: The average workers' comp costs increased by 20 percent in 2001. That's up to $1.80 per $100 of payroll, up from $1.50 a year prior. Surprisingly, Mercer says, nearly half of employers don't allocate these costs back to operating units, which is a proven way of helping to control costs.

Small employers grossly underestimate the possibility of workers between ages 35 and 65 suffering a serious disability, according to a recent survey by the American Council of Life Insurers. Almost half of respondents believe the odds are one in 50, when they're actually one in three.



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