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in the Netherlands
Absenteeism and health problems caused by physically demanding work (in the Netherlands) and ways to prevent this. The role of a health insurance company in guiding employers in keeping their employees vital and healthy. Achmea I Division Care & Healthcare Matti Paulissen Consultant health management Content: 1. Achmea; some figures. 2. Absenteeism in the Netherlands. 3. Absenteeism in Europe, some figures. 4. Good health practices: what a health ensurance company can contribute. 5. The way we advise our customers. 6. Examples successful cases. 7. Future focus 2 1.Achmea; some figures. Introduction Achmea and “Zilveren Kruis” Achmea marketleader CZ-Delta Lloyd UVIT 20% 26% 32% Zilveren Kruis: Number one health ensurance company in employers market: • • • 1994: introduction work related health product 2,45 miljoen customers 60% via employer +/- 17.000 klantrelaties 2. Absenteeism in the Netherlands. Trends in time and cause age musculoskeletal complaints psychological complaints other physical complaints • Absenteeism from 10% in 1980 to a steady 4,5% • Physical and musculoskeletal complaints mainly older ages • Psychological complaints mainly younger ages Source: central buro for statistics Netherlands (CBS) 2. Absenteeism in the Netherlands. Per sector and caused by accidents agriculture financial service providers raw materials extraction Information,communication Information,communication Education hospitality industry Recreation Financials service providers business services Commerce Agriculture Energy Commerce Agriculture Gouverment Recreation Healthcare Commerce Energy Transportation Transportation Industry Construction industry Healthcare hospitality industry Gouvernment Average Source: central buro for statistics Netherlands (CBS) No absenteeism or shorter then one dag At least one day absenteeism 3.Absenteeism in Europe, some key figures. Slovakia Netherlands Average Europe Source: Eurofound (2012), Fifth European Working Conditions Survey, Publications Office of the European Union, Luxembourg. 3.Absenteeism in Europe, some figures. Netherlands Average Europe Slovakia Source: central buro for statistics Netherlands (CBS) 3.Absenteeism in Europe, Cause of absence Source: Eurofound (2012), Fifth European Working Conditions Survey, Publications Office of the European Union, Luxembourg. Conclusions Absenteeism • Absenteeism in Netherlands is stable around 4,5%. • Absenteeism in Slovakia is relatively low, but the perception of health risk in Slovakia is relatively high. • Europe: Sectors with high absenteeism: government, healthcare and industry. • Europe: Sectors with high absenteeism due to accidents: energy, construction, and transportation. • Europe: Main causes absenteeism: Mental (especially at a young age) and physical (especially in old age) • Europe:Physical complaints mainly caused by (lower) back problems. 4. Good health practices: what a health ensurance company can contribute. win-win-win-win Healthy & vital now and future Easier to do your job 2,45 million customers 60% through employer Best and affordable health care(insurance) The healthy enterprise partner for companies Most trusted insurer 2020 Reduce costs & improve quality of care Vital and motivated employees Better position on the labour market Increase productivity & reduce absenteeism & costs Economic prosperity Social trends such as population ageing and less young people Affordable health care , now and in the future 5. The way we advise our customers. Improvement cycle Advice: Consultant provides creative and appropriate advice about a practible and feasible plan based on a clear problem analysis Insight: Appropriate and leading knowledge and insights and inspiring communication Examples: data analysis, CarePlus, customer research, conference Healthy Enterprise, best practices HEALTHY ENTERPRISE SOLUTIONS Solutions: Effective products and services that contribute to the achievement of organizational goals and that offer the customer good service and comfort Programs aimed at Prevention, Improvement & Remedy Insure for care, absenteïsme and income 11 Insight: What are the demographical features of the insured employees at Achmea? Age of employees insured Market share Insurance companies in NL [% of employees subdivided by age classification, 2013] 18-29 24% 30-39 21% 40-49 24% 50-59 21% Most common Social Economic Status (SES) 60-65 11% [% of employes subdivided by SES-categorie, 2013] Least Wealthy employees 19% Gender of employees insured [% of employees, 2013] Average Wealthy employees 58% Man Woman 44% Less Wealthy employees 42% Wealthiest employees 20% 16% Insight: What is the health situation of Dutch employees insured at Achmea? 2,011,311 Total insured employees at Achmea Insured employees subdivided by health group [number and percentage, 2013] Healthy employees 1,172,991 Employees with moderate Health Unhealthy employees 685,945 58% 34% 152,375 8% 13 What are the most common diseases of the posture and musculoskeletal at various sectors in NL? Number of employees with disease [2013] Arthritis Construction Industry Total insured employees 35,678 Systemic connective tissue disorders 977 Bursitis 694 Hernia Arthritis Bursitis Industry Total insured employees 73,591 56,444 13,092 1,538 342 16% 12,675 13% 13% 571 687 3% 1,363 656 Bursitis 12% 17% Ruptured Meniscus 1,369 9% 594 755 10,914 Actual versus expected number of diseases [2013] 876 853 Systemic connective tissue disorder Total insured employees 397 5,982 Hernia Arthritis Transport & Logistics 6,539 Expected number of employees with disease [2013] 10,448 1,227 635 15% 4% 8% 12% 6. Advice and solutions: Examples successful cases. Effects from incompany physiotherapy in health care benefits and health costs Locations1 offered treatments • General physiotherapy • group Treatment • manual therapy Employees using in company physiotherapy • Are mainly man • Average age 50 or less • Top 3 complaints: Back problems 41% Problems with knee / lower leg / foot 14% Problems with shoulder or arms 13% Employees entering the Pilot project of physiotherapy for the analysis are divided into three groups All users of physiotherapy Using only company in physiotherapy Using only traditional physiotherapy Using both traditional and in compagny physiotherapy Case group Controll group Exclusive group 1 6 De case group absenteeism decreases by 27% Probability of absenteeism, average duration per case and average number of days per person adjusted for long term dissease1 Case groep1 Controle groep1 Change on absenteeism Case Group Average number of days per person Average duration 26% X Controll Group 5,3 21 33% = 22 -27% 7,3 1) Correction made by selecting only those persons where the absenteeism looks "normal" so no long-term illness (25% of total( 1 7 In company users barely lower health insurance costs Case group Controll group Average health care costs Case group 1.168 -3% Controll group 1.209 1 8 6. Advice and solutions: Effects from incompany training on the Job in combination a life style programm in reducing complaints • • • • Reduction of lower back complaints 25% Reduction of obesity 28% Reduction of overweight only 2% 60% more conformation to fitness standard MAN Dealers Benchmark Pon (n = 6033) No complaints Complaints Benchmark NL MAN 2011 (n = 181) MAN 2015 (n = 181) 53% 47% 50% 50% 63% 37% Lower back complaints 23% 29% 19% Related to work Not related to work 26% 74% 25% 75% 23% 77% 17% 83% Obesity Overweight BMI > 25 Normal weight < 25 9% 38% 53% 13% 47% 40% 11% 42% 47% 8% 41% 51% not active Dutch Healthy Exercise Standard Fitness standard 39% 33% 24% 56% 66% 18% 49% 24% 28% 20% 16% 26% 6. Advice and solutions: Examples successful cases. Laevo; reducing lower back complaints with innovative solution Posture and frequent bending factor in lower back complaints 35% dutch employees have working postures that can cause lower back pain 11% industry 16% healthcare Bronnen: NEA, 2009 21 TNO/VU research: Laevo Power Supply Low lower back muscles 18 16 14 Muscle tension 12 10 8 6 Normal 4 2 Normal Laevo Laveo -44% -37% Angled back muscles Straight back muscles 0 TNO/VU research – statische en dynamische taken – bij 18 proefpersonen Physical exposure decreases (n=74) Fysiek zwaar werk I have physically demanding work Eind van de dag fysiek uitgeput At the end of the day I am exhausted Met de Laevo fysiek zware taken langer volhouden With Laevo it is easier to continue working ondersteund door de Laevo theVoldoende laevo supports me enough Delaevo Laevo zal voorkomen dat ik lage rugklachten krijg the will avoid getting low back pain 0 Eens 20 Eens/Oneens 40 60 80 100 Oneens Agree Agree nor disagree disagree 23 Sustainable employability improves th, I expectIktoverwacht carryditout work until my67e 67uit werkthis ZONDER LAEVO tot mijn te kunnen voeren without Laevo th, Ik verwacht dit werk LAEVO tot mijn 67e my uit te67 kunnen I expect to carry outMET this work until voeren with Laevo +20% Ik verwacht dit werk dework Laevo langer uit te kunnen I expect to carry out met this much longer voeren with Laevo 0 Eens Eens/Oneens 20 Oneens 40 60 80 Agree Agree nor disagree disagree 100 24 Conclusions Examples successful cases • Companies need best cases: Achmea has over 30 best cases. • Benefits for employers are: a decrease in the number of health complaints, less absentheeism, good employment practices, better motivated employees and, in the end a higher sustainable production capacity. • More partnership with our customers. • In the end: lower costs for health care. • We need to improve on methods to measure results and build business cases. • We need to improve on methods to reach more employees. Future Focus • Measuring the effects of prevention. • A shift from lowering absenteeism to prevention and resillience. • Further investigation into the possibilities of E-health and M-health • A shift from single solution projects to policy consultancy. We believe that employers play an important role in maintaining the health of their employees. We, as Achmea, are willing to play a leading role, in partnership with employers, through innovative projects and services, to keep The Netherlands a healthy country. Appendix 2. Absenteeism in the Netherlands. Relationship with work Average Financials Gouvernment Recreation Commerce Communication Healthcare Business services Transportatio Energy Construction industry Education hospitality industry % absenteeism Yes, mainly caused by working conditions No, for the lesser part caused by working conditions Source: central buro for statistics Netherlands (CBS) 3.Exposure to physical risk in Europe, Increase or decrease per sector Increase Increase Decrease Decrease Source: Eurofound (2012), Fifth European Working Conditions Survey, Publications Office of the European Union, Luxembourg. Most common diseases which affects Dutch employees Percentage of insured employees subdivided by type of disease [% of main group, 2013] Mental disease Percentage of employees insured Description of disease 16% Number of employees with disease 256,850 Inflammation / infections 222,330 Arthritis 184,354 Skin disease Mental diseases Upper respiratory disease Hay Fever Heartburn Asthma/ COPD Other physical disease 31% [2013] Cardiovascular disease Disease of the posture and musculoskeletal 173,548 159,980 138,979 129,144 98,883 88,789 78% Percentage of employees in NL with disease [2013] 13% 11% 9% 9% 8% 7% 6% 5% 4% 7. Future Focus: Standardization of measurement instruments to show differences in effectiveness between interventions and providers @home Psychological care Psychological Labour rehabilitation @risk @work Psychological care Staff welfare Reintegration Posture and musculoskeletal Physical rehabilitation Physical rehabilitation ) Labour rehabilitation Fysio therapy Fysio therapy RSI program Prevention (physical) Coaching Reintegration Labour rehabilitation Prevention (physical) Sleeping/ snorring Prevention (physical) Remaining physical Coaching Lifestyle training Lifestyle Quit smoking Nutrition program Prevention (physical)
