title: Cost-effectiveness and cost-benefit analyses of a multidisciplinary intervention compared with a brief intervention to facilitate return to work in sick-listed patients with low back pain.
abstract: METHODS
  Randomized clinical trial of 2 interventions in 351 employees sick listed due to low back pain (LBP) and a subsequent validation study (n = 120) to validate results from subgroup analyses in the original study.
  
  
  OBJECTIVE
  To compose health economic analyses (cost-effectiveness- and cost-benefit analyses) of multidisciplinary versus brief intervention by calculating health care sector costs and sick leave benefits.
  
  
  BACKGROUND
  Both brief and multidisciplinary interventions have been reported to be superior relative to usual care when comparing intervention costs with saved costs for sick leave benefits. We reported similar return to work rates in a brief and a multidisciplinary intervention group, but different return to work rates in subgroups.
  
  
  METHODS
  The brief intervention comprised clinical examination and reassuring advice. The multidisciplinary intervention was conducted by a case manager and a team of specialists. The costs of medicine, health care services, and sick leave benefits were calculated on the basis of registers.
  
  
  RESULTS
  The mean intervention cost per patient was € 1377 higher in the multidisciplinary intervention (n = 176) than in the brief intervention group (n = 175), and sick leave was not averted. However, sick leave was averted in a subgroup receiving the multidisciplinary intervention and the mean incremental intervention cost for 1 saved sick leave week in this subgroup (n = 60) of patients, who thought they were at risk of losing their job or had little influence on their work situation was € 217. The latter finding was verified in the validation study (n = 28).
  
  
  CONCLUSIONS
  The brief intervention resulted in fewer sick leave weeks and was less expensive than the multidisciplinary intervention. The multidisciplinary intervention only outperformed the brief intervention in terms of costs in a subgroup of sick-listed employees who thought they were at risk of losing their job or had little influence on their work situation.
  
  
  METHODS
  2.
authors: Department of Clinical Social Medicine, Public Health and Quality Improvement-Central Denmark Region, Institute of Public Health, University of Aarhus, Midtbyen, Aarhus, Denmark. chris.jensen@air.no
authors: Chris
authors: C
authors: Jensen
authors: Claus Vinther
authors: CV
authors: Nielsen
authors: Ole Kudsk
authors: OK
authors: Jensen
authors: Karin Dam
authors: KD
authors: Petersen
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000706:statistics & numerical data; D010147:Pain Measurement; D062707:Return to Work / Q000191:economics* / Q000706:statistics & numerical data; D018582:Sick Leave / Q000191:economics* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires