Editorial


 4

Editorial 
 

PRIMARY CARE IN THE WORKPLACE: 
COST SAVINGS AND IMPROVED HEALTH OUTCOMES 

 
Melondie Carter 

 Editorial Board Member 
 

 
The major portion of health care dollars is spent on illness care and yet the health 

outcomes of the United States are poorer than many countries that spend much less. A 
shift must occur in spending to place more emphasis on prevention. Increasing health 
promotion and wellness programs in industries is one prevention strategy for decreasing 
health care costs and improving health outcomes. Although the workplace is a logical site 
for health promotion, few small employers offer programs and few understand how to 
balance program costs against benefits. Yet, while at work, the employees are a captive 
audience and are more likely to engage in wellness activities. 

There are numerous reasons for incorporating wellness programs in small 
industries. Considering the high percentage of illnesses that can be prevented, that most 
small industries are self insured and the rising health care costs, health promotion and 
prevention programs are gaining popularity. Two chronic diseases which are readily 
impacted are cardiovascular disease and diabetes mellitus. In 2001, the Healthcare 
Utilization Project was conducted by AHRQ to determine average hospital discharge 
costs and length of stays for diagnosis. On average one hospital discharge for diabetes 
with complications costs $15,721; on average one hospital discharge for hypertension 
with complications costs $18,955 and a coronary artery bypass graft costs $60,853. When 
employers are made aware of these potential costs, wellness programs cost effectiveness 
becomes more apparent. Besides decreasing the incidence of possible costly 
hospitalizations, employee productivity and morale can increase with wellness care. 

One model for a wellness program in small industries includes nurse practitioners 
and nurse case managers working as a team. Nurse practitioners provide physicals and 
lab work screenings and a nurse case manager provides follow-up on lab values and 
individualized health teaching. This prevention model has proven to improve the 
population’s health outcomes and has provided cost savings for the involved industries. 
 

REFERENCE 
 
Healthcare Cost and Utilization Project. (2001). National Inpatient Sample database. 

Retrieved November 5, 2005, from http://www.ahcpr.gov/data/hcup/hcupnis.htm

Online Journal of Rural Nursing and Health Care, vol. 6, no. 1, Spring 2006 
 

 

http://www.ahcpr.gov/data/hcup/hcupnis.htm