The Hidden Costs of Illness: Chronic Disease Management in the Maritime Sector


The Hidden Costs of Illness: Chronic Disease Management in the Maritime Sector

According to the World Health Organization, noncommunicable diseases and health conditions such as cardiovascular diseases, chronic respiratory diseases and diabetes account for nearly three-quarters of deaths worldwide.

Some 77% of these deaths occur in low to middle income countries, where heightened risk factors, such as tobacco and alcohol use, lack of exercise and an unhealthy diet, increase cases of high blood pressure, obesity, elevated blood sugar and more. Further, about 80% of the world’s seafarers come from developing or third-world countries.

The result is that compared to shoreside professionals, seafarers have an elevated risk of developing chronic health conditions, which carries broad economic implications. Chronic conditions cost maritime operators millions of dollars a year.

These diseases can be managed at sea, but it will take a new approach to healthcare. For decades, medicine at sea has been reactive – treating an illness, dressing an injury, etc. However, the future of the maritime industry depends on keeping workers safe, healthy, and productive by finding new ways to reduce and manage chronic illness.

The Power of Risk Reduction

Risk reduction is integral to the maritime industry’s healthcare goals, especially when it comes to preventing and managing chronic conditions.

Studies have shown that basic lifestyle changes, such as increased physical activity, balanced nutrition and better weight management, can reduce the risk of developing cardiovascular disease by more than 80% and diabetes by more than 90%.

Lower blood pressure, which can be achieved through basic lifestyle modifications, correlates directly with a reduced risk of myocardial infarction, stroke and heart failure. In fact, a controlled study on the impact of lifestyle changes found a 67% reduction in the risk of developing type 2 diabetes by making simple adjustments to diet and exercise.

The Economics of Ill Health at Sea

Hospital stays are exorbitantly expensive. According to a four-year study at Yale University, illness claims account for half of all medical events (49%), with a direct cost of $18.5M. Cardiovascular disease alone has a direct cost of $5.7M. However, while hospital admissions account for only 2.4% of medical encounters, they consume 56% of medical costs.

So, let’s talk about crew health in a language that every maritime operator understands: Money. Chronic disease wreaks economic havoc in a number of ways.

First, it impacts crew availability and costs. More than 10,000 seafarers a year lose their job after Pre-Employment Medical Examinations (PEME) detect chronic illness. The most common issues are high blood pressure and diabetes, which tend to present after age 45. This has led to a predicted shortfall of 90,000 trained officers by 2026.

These seafarers excluded from the workforce need to be replaced, but between funnel selection, training and agency fees (or, alternatively, department costs), the cost of recruiting just one replacement candidate can easily top $40,000.

Second, chronic diseases increase disembarkations. On average, the cost of a medical diversion and repatriation event is $180,000. About 60% of this is direct costs, such as diverting the route, transportation from ship to hospital, in-patient care, repatriation and sick benefits. The other 30% is indirect costs, such as lost productivity, unforeseen port fees, replacement labour, overtime pay and case administration.

Ultimately, ill health creates a vicious cycle: Crews are left short-handed by chronic disease, putting more responsibility and pressure on remaining workers. As fatigue sets in and stress builds, the risk of injury rises, as does the threat of burnout, depression, and further disembarkations and shortages, resulting in even less productivity.

There is a clear financial incentive to improve seafarer health by introducing and/or strengthening cost-effective initiatives that promote health and prevent disease.

Real Cases, Real Costs

In 2011, a male seafarer was evacuated by helicopter to the port of Bergen, Norway, after experiencing an acute myocardial infarction. He was hospitalised for 12 days before returning to his home country. The total cost of this health event was €98, 823, driven mainly by the cost of hospital treatment, which totaled €44, 170.

In another case, a male engineer was evacuated to the port of Shanghai for a medical examination due to high blood pressure, where he was found to be suffering from malignant hypertension. The ship sailed off course for six hours to reach the port of Shanghai, at an estimated cost of €47,597. The deviation alone generated €13,200 in direct costs, and more in indirect costs from lost productivity.

Nearly €150,000 spent on addressing cardiovascular issues in two workers. Now, imagine the impact of investing that much money in preventive healthcare.

OneHealth by VIKAND: A Solution for Chronic Disease

Recognising the impact of comprehensive healthcare at sea, VIKAND developed OneHealth – a proactive, comprehensive suite of tools and services designed to maximise onboard health and wellbeing.

OneHealth can help seafarers living with chronic medical conditions optimise their health, reduce sick days and work more productively through a number of strategies. For hypertension, OneHealth offers daily blood pressure monitoring, medication management and regular follow-ups with a doctor. For diabetes, we conduct daily random blood sugar monitoring, plus med management and physician follow-ups.

However, we also provide crew chronic disease resources, including lifestyle modification guidance and diet counselling. Our goals are, in this order: 1) prevent chronic conditions, 2) reverse chronic conditions, if possible, and 3) help workers live healthy, productive lives while managing chronic conditions.

We help seafarers manage chronic illnesses via OneHealth with easy-to-schedule chronic disease reviews, robust physical and mental wellness resources, an online dashboard for managing important health information, chronic disease monitoring equipment, professional consultations and monitoring via Telehealth, and more.

OneHealth is also an investment in workforce and operational stability. A healthier, more experienced crew has fewer accidents and injuries, which reduces all types of costs, including insurance, diversions, medical bills, sick pay, lost productivity and more. For an industry already facing staffing challenges and a looming officer shortage, it’s never been more important to retain – and maintain – experienced crews. This is achievable through a total healthcare solution that helps manage chronic conditions, reduce risk, and nurture the type of work environment that can attract and retain global talent.

A Future Worth Investing In

As healthcare evolves, so should our expectations of chronic disease. On one hand, we must recognize that the most common noncommunicable diseases responsible for early mortality are largely preventable through lifestyle modifications. On the other hand, we must appreciate the fact that today’s healthcare knowledge makes it possible to live a long, productive life even with a chronic illness.

The future of the maritime industry hinges directly on the availability of qualified, capable workers. Without them, this industry – and the global economy – will soon find themselves beached. With the right vision and investments, chronic health issues can be prevented, reversed or intelligently managed, removing a major threat to the economic sustainability of oceangoing commerce.

Subscribe to our VIKAND Pulse to receive the latest maritime healthcare news from VIKAND sent right to your inbox

Subscribe to our VIKAND Pulse to receive the latest maritime healthcare news from VIKAND sent right to your inbox

Subscribe to our VIKAND Pulse to receive the latest maritime healthcare news from VIKAND sent right to your inbox

Subscribe to our VIKAND Pulse to receive the latest maritime healthcare news from VIKAND sent right to your inbox
Subscribe to our VIKAND Pulse to receive the latest maritime healthcare news from VIKAND sent right to your inbox