Hospital referral regions (HRRs) are 306 distinct areas across the U.S. where patients receive regional medical care. Developed for the Dartmouth Atlas Project and used by researchers and the federal government, HRRs provide a uniform boundary to examine disparities in health care utilization and spending. Since its inception in 2008, the Gallup-Healthways Well-Being Index™ (WBI) has been measuring subjective well-being in the U.S. at national, state, and regional levels. The objective of this paper is to determine the correlation between WBI scores and rates of disease and health care utilization at the HRR level. The analysis utilized 2008 to 2010 publicly available HRR-level data of Medicare fee-for-service beneficiaries age 65 or older.
In general, the cross-sectional analyses resulted in negative correlation coefficients between the WBI and rates of disease and utilization, meaning HRRs with higher well-being had lower disease and utilization. Rates of heart attack, failure, and disease; chronic obstructive pulmonary disease; diabetes; and hypertension were correlated with the composite WBI and emotional health, physical health, healthy behavior, and basic access sub-indices of the WBI. Inpatient stay rates and emergency department visits per 1,000 beneficiaries were correlated with the composite WBI and life evaluation, emotional health, physical health, healthy behavior, and basic access sub-indices. Hospital readmission rates were correlated with the composite WBI and emotional health and healthy behavior sub-indices.
Overall, the results corroborate the WBI as a holistic measure of well-being and clinical health at the regional level. The results also suggest well-being has a moderate to high relationship with key drivers and measures of health care utilization.
Outcomes and Insights in Health Management is a Healthways publication that covers scientific research that was elected to not be submitted for peer review.