4.1 Article

THE ANALYSIS OF SCREENING COSTS FOR HYPERCHOLESTEROLEMIA AND HYPERGLYCEMIA AS PART OF OBLIGATORY EXAMINATIONS OF EMPLOYEES

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NOFER INST OCCUPATIONAL MEDICINE, POLAND
DOI: 10.13075/ijomeh.1896.01708

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screening; dyslipidemia; cost-effectiveness; economic evaluation; hyperglycemia; occupational health programs

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In Poland, mandatory employee medical check-ups are a cost-effective method for early detection of hyperlipidemia and hyperglycemia. A study involving university employees found that 65.9% had dyslipidemia and 31% had hyperglycemia. The total cost of detecting a single case of dyslipidemia and hyperglycemia was EUR 3.88 and EUR 3.09 respectively, with lower costs for older employees. Due to high reporting rates, occupational screening tests for these disorders may be more cost-effective than general population screening.
Objectives: High prevalence of hyperlipidemia and hyperglycemia requires searching for efficient and cost-effective methods of an early detection of these disorders. In Poland, obligatory employee medical check-ups could be a solution. Material and Methods: The study included a group of university employees who underwent obligatory occupational examinations in 2018. Each employee had an additional lipid (unit cost: EUR 2.56) and blood glucose profile (EUR 0.93) done. The number of respondents involved in the study was 850 (340 males and 510 females), and their average age was 47 years (SD = 11 years). The education distribution was as follows: employees with secondary vocational and general education (physical, frontline and administrative workers): 176 (age: M +/- SD 50.3 +/- 10.3); employees with a university degree (academics with an M.Sc. or/and Ph.D. title and administrative staff): 535 (age: M +/- SD 43.6 +/- 9.8); and academics with a university title (Ass. Prof. and/or Prof.): 139 (age: M +/- SD 56.2 +/- 10.2). Results: Dyslipidemia (elevated total cholesterol >= 190 mg/dl and/or low-density lipoprotein cholesterol >= 115 mg/dl) was reported in 560 workers (65.9%). Hyperglycemia (fasting glucose >= 100 mg/dl) was observed in 256 workers (31%). The total cost of detecting a single case of dyslipidemia and hyperglycemia was EUR 3.88 and EUR 3.09, respectively. Divided by age groups, the costs were as follows: EUR 4.34 and EUR 4.53 in the age group <45 years; EUR 3.56 and EUR 2.42 in the age group >= 45 years. The costs of detecting a single case of dyslipidemia and hyperglycemia in employees aged >= 45 with regard to education were as follows: EUR 3.20 and EUR 2.07 in persons with secondary vocational and general education; EUR 3.40 and EUR 2.80 in persons with a university degree; and EUR 4.38 and EUR 2.28 in persons with a university title. Conclusions: Due to the fact that the reporting rate for screening tests in the framework of occupational medicine is high, the cost of occupational screening tests for dyslipidemia and hyperglycemia can be lower than the cost of screening tests in the general population.

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