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Am J Manag Care. 2001 Jan;7(1):27-34.

Indirect cost of ischemic heart disease to employers.

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Outcomes Research and Management, Merck & Co Inc, West Point, PA, USA.



The management of healthcare programs by employers requires accurate information about the indirect and direct costs of important chronic diseases.


To determine the indirect costs of ischemic heart disease from the perspective of the employer in private industry in the United States.


Indirect cost of illness analysis using the human capital approach, taking the perspective of the employer rather than that of society.


Ischemic heart disease was identified in a proprietary claims database of 3.1 million insured persons using an algorithm based on administrative codes. Economic data were derived from the Bureau of Labor Statistics, the Employment Management Association, and published sources. Work-loss data were taken from the National Center for Health Statistics' Health Interview Survey. The indirect cost was calculated as the sum of the costs due to morbidity and mortality. From the perspective of the employer, morbidity costs come from lost productivity, idle assets, and nonwage factors resulting from absenteeism and mortality costs are expenditures for replacing and retraining workers. This differs from calculations from the societal perspective, in which indirect costs are the value of an individual's lost income--both current and potential.


The total indirect cost of ischemic heart disease to employers in private industry was $182.74 per enrollee. Ninety-five percent of the indirect cost was the consequence of work loss due to morbidity rather than of mortality costs.


From the perspective of the employer, the indirect cost of ischemic heart disease is overwhelmingly due to morbidity costs.

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