title: Economic evaluation of a participatory return-to-work intervention for temporary agency and unemployed         workers sick-listed due to musculoskeletal disorders.
abstract: OBJECTIVE
  The aim of the study was to evaluate the cost-effectiveness, -utility, and -benefit of a newly         developed participatory return-to-work (RTW) program for temporary agency and unemployed workers, sick-listed due to         musculoskeletal disorders.
  
  
  METHODS
  An economic evaluation was conducted alongside a randomized controlled trial with a         12-month follow-up. Temporary agency and unemployed workers, sick-listed for 2â€"8 weeks due to         musculoskeletal disorders, were randomized to the participatory RTW program (N=79) or usual care group (N=84). The new         RTW program was aimed at making a consensus-based RTW action plan with the possibility of a temporary (therapeutic)         workplace. Effect outcomes were sustainable RTW and quality-adjusted life years (QALY). Healthcare utilization was         measured from the social insurerâ€™s perspective and societal perspective.
  
  
  RESULTS
  Total healthcare         costs in the participatory RTW program group [10 189 (standard deviation [SD] 7055) euros] were statistically         significantly higher compared to care-as-usual [7862 (SD 7394) euros]. The cost-effectiveness analyses showed that the         new intervention was more effective but also more costly than usual care (ie, to gain RTW one day earlier in the         participatory RTW program group approximately 80 euros needed to be invested). The net societal benefit of the         participatory RTW program compared to care-as-usual was 2073 euros per worker.
  
  
  CONCLUSIONS
  The newly developed         participatory RTW program was more effective but also more costly than usual care. The program enhanced work resumption         and generated a net socioeconomic benefit. Hence, implementation of the participatory RTW program may have potential to         achieve a sustainable contribution of vulnerable workers to the labor force.
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Sylvia J
authors.initials: SJ
authors.lastname: Vermeulen
authors.forename: Martijn W
authors.initials: MW
authors.lastname: Heymans
authors.forename: Johannes R
authors.initials: JR
authors.lastname: Anema
authors.forename: Antonius J M
authors.initials: AJ
authors.lastname: Schellart
authors.forename: Willem
authors.initials: W
authors.lastname: van Mechelen
authors.forename: Allard J
authors.initials: AJ
authors.lastname: van der Beek
mesh_terms: D000293:Adolescent; D000328:Adult; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000191:economics*; D009784:Occupational Diseases / Q000191:economics*; D016273:Occupational Exposure; D019057:Quality-Adjusted Life Years; D062707:Return to Work / Q000191:economics*; D018582:Sick Leave / Q000191:economics*; D055815:Young Adult