title: Cost-utility analysis of a one-time supervisor telephone contact at 6-weeks post-partum to prevent extended sick leave following maternity leave in The Netherlands: results of an economic evaluation alongside a randomized controlled trial.
abstract: BACKGROUND
  Working women of childbearing age are a vital part of the population. Following childbirth, this group of women can experience a myriad of physical and mental health problems that can interfere with their ability to work. Currently, there is little known about cost-effective post-partum interventions to prevent work disability. The purpose of the study was to evaluate whether supervisor telephone contact (STC) during maternity leave is cost-effective from a societal perspective in reducing sick leave and improving quality-adjusted life years (QALYs) compared to common practice (CP).
  
  
  METHODS
  We conducted an economic evaluation alongside a randomized controlled trial. QALYs were measured by the EuroQol 5-D, and sick leave and presenteeism by the Health and work Performance Questionnaire. Resource use was collected by questionnaires. Data were analysed according to intention-to-treat. Missing data were imputed via multiple imputation. Uncertainty was estimated by 95% confidence intervals, cost-utility planes and curves, and sensitivity analyses.
  
  
  RESULTS
  541 working women from 15 companies participated. Response rates were above 85% at each measurement moment. At the end of the follow-up, no statistically significant between-group differences in QALYs, mean hours of sick leave or presenteeism or costs were observed. STC was found to be less effective and more costly. For willingness-to-pay levels from €0 through €50,000, the probability that STC was cost-effective compared to CP was 0.2. Overall resource use was low. Mean total costs were €3678 (95% CI: 3386; 3951). Productivity loss costs represented 37% of the total costs and of these costs, 48% was attributable to sick leave and 52% to work presenteeism. The cost analysis from a company's perspective indicated that there was a net cost associated with the STC intervention.
  
  
  CONCLUSIONS
  STC was not cost-effective compared to common practice for a healthy population of working mothers; therefore, implementation is not indicated. The cost-utility of STC for working mothers with more severe post-partum health problems, however, needs to be investigated. Work presenteeism accounted for half of the total productivity loss and warrants attention in future studies.
  
  
  BACKGROUND
  ISRCTN: ISRCTN73119486.
authors.affiliation: Health Technology Assessment Unit, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Kimi
authors.initials: K
authors.lastname: Uegaki
authors.forename: Suzanne G M
authors.initials: SG
authors.lastname: Stomp-van den Berg
authors.forename: Martine C
authors.initials: MC
authors.lastname: de Bruijne
authors.forename: Mireille N M
authors.initials: MN
authors.lastname: van Poppel
authors.forename: Martijn W
authors.initials: MW
authors.lastname: Heymans
authors.forename: Willem
authors.initials: W
authors.lastname: van Mechelen
authors.forename: Maurits W
authors.initials: MW
authors.lastname: van Tulder
mesh_terms: D000288:Administrative Personnel; D000293:Adolescent; D000328:Adult; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008875:Middle Aged; D009426:Netherlands; D016524:Parental Leave / Q000191:economics*; D049590:Postpartum Period; D019057:Quality-Adjusted Life Years; D018582:Sick Leave / Q000191:economics*; D011795:Surveys and Questionnaires; D013689:Telephone; D055815:Young Adult