Cost-Effectiveness of a Problem-Solving Intervention Aimed to Prevent Sickness Absence among Employees with Common Mental Disorders or Occupational Stress

Abstract

The cost-benefit and cost-effectiveness of a work-directed intervention implemented by the occupational health service (OHS) for employees with common mental disorders (CMD) or stress related problems at work were investigated. The economic evaluation was conducted in a two-armed clustered RCT. Employees received either a problem-solving based intervention (PSI; n = 41) or care as usual (CAU; n = 59). Both were work-directed interventions. Data regarding sickness absence and production loss at work was gathered during a one-year follow-up. Bootstrap techniques were used to conduct a Cost-Benefit Analysis (CBA) and a Cost-Effectiveness Analysis (CEA) from both an employer and societal perspective. Intervention costs were lower for PSI than CAU. Costs for long-term sickness absence were higher for CAU, whereas costs for short-term sickness absence and production loss at work were higher for PSI. Mainly due to these costs, PSI was not cost-effective from the employer’s perspective. However, PSI was cost-beneficial from a societal perspective. CEA showed that a one-day reduction of long-term sickness absence costed on average € 101 for PSI, a cost that primarily was borne by the employer. PSI reduced the socio-economic burden compared to CAU and could be recommended to policy makers. However, reduced long-term sickness absence, i.e., increased work attendance, was accompanied by employees perceiving higher levels of production loss at work and thus increased the cost for employers. This partly explains why an effective intervention was not cost-effective from the employer’s perspective. Hence, additional adjustments and/or support at the workplace might be needed for reducing the loss of production at work.

Management of chronic low back pain and the impact on patients’ personal and professional lives: Results from an international patient survey

“… 62 In addition, chronic musculoskeletal pain, psychological comorbidity, and pain‐related fear of movement are associated with low work productivity and negative impacts on work‐related outcomes. 6 , 63 , 64 Taken together, the evidence suggests a 2‐way association between CLBP severity and work‐related impact, with patients facing both physical and emotional barriers in the workplace. 65 , 66 This further supports previous research by the Lancet Low Back Pain Series Working Group and others, which highlights the need for improved communications between employers and patients in the workplace, as well as streamlined integration between healthcare services, employers, and social services to fully support CLBP patients.…”

“…The mental strain associated with job insecurity and workplace hostility may be worse for the health of workers than unemployment 61 and are associated with onset of CLBP 62 . In addition, chronic musculoskeletal pain, psychological comorbidity, and pain‐related fear of movement are associated with low work productivity and negative impacts on work‐related outcomes 6,63,64 . Taken together, the evidence suggests a 2‐way association between CLBP severity and work‐related impact, with patients facing both physical and emotional barriers in the workplace 65,66 .…”

The Cost-Effectiveness Analysis of the Productivity Measurement and Enhancement System Intervention to Reduce Employee Work-Related Stress and Enhance Work Performance

“…The types of interventions that have been studied have emphasized individualcentered interventions (i.e., problem solving) [14][15][16], adequacy of the interventions delivered [17][18][19], and interventions where the worker and supervisor identify challenges and develop a plan for new working arrangement (i.e., participatory interventions) [20]. Participatory work-focused interventions are recommended comprehensive strategies for addressing the causes of work stress and depression, such as psychosocial and organizational hazards.…”

Cost-effectiveness of comprehensive preventive measures for coal workers’ pneumoconiosis in China

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