Economic evaluation of occupational health and safety programmes in health care.
BACKGROUND
Evidence-based resource allocation in the public health care sector requires reliable economic evaluations that are different from those needed in the commercial sector.


OBJECTIVE
To describe a framework for conducting economic evaluations of occupational health and safety (OHS) programmes in health care developed with sector stakeholders. To define key resources and outcomes to be considered in economic evaluations of OHS programmes and to integrate these into a comprehensive framework.


METHODS
Participatory action research supported by mixed qualitative and quantitative methods, including a multi-stakeholder working group, 25 key informant interviews, a 41-member Delphi panel and structured nominal group discussions.


RESULTS
We found three resources had top priority: OHS staff time, training the workers and programme planning, promotion and evaluation. Similarly, five outcomes had top priority: number of injuries, safety climate, job satisfaction, quality of care and work days lost. The resulting framework was built around seven principles of good practice that stakeholders can use to assist them in conducting economic evaluations of OHS programmes.


CONCLUSIONS
Use of a framework resulting from this participatory action research approach may increase the quality of economic evaluations of OHS programmes and facilitate programme comparisons for evidence-based resource allocation decisions. The principles may be applicable to other service sectors funded from general taxes and more broadly to economic evaluations of OHS programmes in general.
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
J
J
Guzman
Institute for Work and Health, Toronto, Ontario, Canada.
E
E
Tompa
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
M
M
Koehoorn
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
H
H
de Boer
Institute for Work and Health, Toronto, Ontario, Canada.
S
S
Macdonald
Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, San Antonio, TX, USA. Abul.h.alamgir@uth.tmc.cedu.
H
H
Alamgir
D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics*; D006302:Health Services Research; D006801:Humans; D016272:Occupational Health; D015397:Program Evaluation / Q000191:economics*; D011634:Public Health
Health economics; health and safety management; intervention; occupational health.