Economic evaluation of a problem solving intervention to prevent recurrent sickness absence in workers with common mental disorders.
OBJECTIVE
Workers with common mental disorders (CMDs) frequently experience recurrent sickness absence but scientifically evaluated interventions to prevent recurrences are lacking. The objectives of this study are to evaluate the cost-effectiveness and cost-benefit of a problem solving intervention aimed at preventing recurrent sickness absence in workers with CMDs compared to care as usual.


METHODS
An economic evaluation was conducted alongside a cluster-randomised controlled trial with 12 months follow-up. Treatment providers were randomised to either a 2-day training in the SHARP-at work intervention, i.e. a problem solving intervention, or care as usual. Effect outcomes were the incidence of recurrent sickness absence and time to recurrent sickness absence. Self-reported health care utilisation was measured by questionnaires. A cost-effectiveness analysis (CEA) from the societal perspective and a cost-benefit analysis (CBA) from the employer's perspective were conducted.


RESULTS
The CEA showed that the SHARP-at work intervention was more effective but also more expensive than care as usual. The CBA revealed that employer's occupational health care costs were significantly higher in the intervention group compared to care as usual. Overall, the SHARP-at work intervention showed no economic benefit compared to care as usual.


CONCLUSIONS
As implementation of the SHARP-at work intervention might require additional investments, health care policy makers need to decide if these investments are worthwhile considering the results that can be accomplished in reducing recurrent sickness absence.
Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. i.arends@umcg.nl
Iris
I
Arends
Ute
U
Bültmann
Willem
W
van Rhenen
Henk
H
Groen
Jac J L
JJ
van der Klink
D000328:Adult; D003362:Cost-Benefit Analysis; D017598:Efficiency, Organizational / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000191:economics* / Q000453:epidemiology; D008875:Middle Aged; D009786:Occupational Health Services / Q000191:economics; D011340:Problem Solving; D015397:Program Evaluation; D018582:Sick Leave / Q000191:economics*