Cost-effectiveness of guideline-based care for workers with mental health problems.
OBJECTIVE
To evaluate the cost-effectiveness of an activating guideline-based care (GBC) by occupational physicians (OPs).


METHODS
An economic evaluation was conducted in a randomized controlled trial with police workers on sick leave due to mental health problems (n = 240). In the intervention group trained OPs provided GBC, compared with usual care with easy access to a psychologist. Sick leave data and health care costs were gathered after 1-year follow-up. Analyses comprised bootstrap techniques, cost-effectiveness planes, and acceptability curves.


RESULTS
Health care utilization costs (euro574.532 in total) were significantly lower in the intervention group (mean difference -euro520; 95% CI -euro980 to euro59), whereas there were no significant differences in days of sick leave and productivity loss costs.


CONCLUSIONS
GBC could be cost-effective, as lower direct costs lead to equal treatment outcomes of workers with common mental disorders.
Rebergen
D S
DS
Department of Public and Occupational Health, EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands.
Bruinvels
D J
DJ
van Tulder
M W
MW
van der Beek
A J
AJ
van Mechelen
W
W
D000328:Adult; D003362:Cost-Benefit Analysis; D004526:Efficiency; D005260:Female; D017408:Guidelines as Topic; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D016272:Occupational Health; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D018582:Sick Leave