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Economic evaluation of a workplace intervention for sick-listed employees with distress
  1. Sandra H van Oostrom1,2,
  2. Martijn W Heymans3,4,
  3. Henrica C W de Vet3,
  4. Maurits W van Tulder3,4,
  5. Willem van Mechelen1,2,5,
  6. Johannes R Anema1,2,5
  1. 1Department of Public and Occupational Health and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
  2. 2Research Center on Physical Activity, Work and Health, VU University Medical Center, Amsterdam, The Netherlands
  3. 3Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
  4. 4Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
  5. 5Dutch Research Center for Insurance Medicine AMC-UWV-VUmc, VU University Medical Center, Amsterdam, The Netherlands
  1. Correspondence to Johannes R Anema, Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands; h.anema{at}vumc.nl

Abstract

Objectives To evaluate the cost effectiveness, cost utility and cost benefit of a workplace intervention compared with usual care for sick-listed employees with distress.

Methods An economic evaluation was conducted alongside a randomised controlled trial. Employees with distress and who were sick-listed for 2–8 weeks were randomised to a workplace intervention (n=73) or to usual care (n=72). The workplace intervention is a stepwise process involving the sick-listed employee and their supervisor, aimed at formulating a consensus-based plan for return to work (RTW). The effect outcomes were lasting RTW and quality-adjusted life years (QALYs). Healthcare utilisation was measured over 12 months. Cost effectiveness analyses (CEA) and cost utility analyses (CUA) were conducted from the societal perspective and cost benefit analyses (CBA) from the employer perspective. Bootstrapping techniques were used to estimate cost and effect differences, related CIs, and cost effectiveness and cost utility ratios. Cost effectiveness planes were presented and subgroup analyses were performed.

Results CEA and CUA revealed no statistically significant differences in lasting RTW, QALYs or costs. The CBA indicated a statistically significant higher cost of occupational health services in the workplace intervention group. The workplace intervention was not cost effective according to the CEA, CUA and CBA.

Conclusions Widespread implementation of the workplace intervention for sick-listed employees with distress is not recommended because there was no economic benefit compared with usual care. Future trials should confirm if the workplace intervention is cost effective for the subgroup employees who intended to return to work despite symptoms.

This trial has been registered at the Dutch National Trial Register ISRCTN92307123.

  • Participatory workplace intervention
  • distress
  • return to work
  • RCT
  • economic evaluation
  • mental health
  • occupational health practice
  • intervention studies

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Footnotes

  • Linked articles 050849.

  • Funding This study is financially supported by the Dutch Ministry of Social Affairs and Employment and the participating occupational health services.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Medical Ethics Committee of the VU University Medical Center.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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