Economic Evaluation of a Participatory Return-to-Work Intervention for Temporary Agency and Unemployed Workers Sick-Listed due to Musculoskeletal Disorders

• Published in: Scandinavian Journal of Work, Environment ＆ Health Environment ＆ Health, 2013-01, Vol.39 (1), p.46-56
• Main Authors: Vermeulen, Sylvia J, Heymans, Martijn W, Anema, Johannes R, Schellart, Antonius JM, van Mechelen, Willem, van der Beek, Allard J
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Clinical trials; Cost analysis; Cost efficiency; Costs and Cost Analysis; cost–benefit analysis; cost–effectiveness analysis; Diseases of the osteoarticular system; Economic costs; economic evaluation; Employment contracts; evaluation; Female; Health care; Health care costs; Health care expenditures; Health care industry; Humans; Intervention; Labor contracts; Labor costs; Labor force; labor force participation; Male; Medical sciences; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; msd; Musculoskeletal diseases; Musculoskeletal Diseases - economics; musculoskeletal disorder; Occupational Diseases - economics; Occupational Exposure; Productivity; Quality-Adjusted Life Years; Return to Work - economics; return-to-work; Sick Leave - economics; social insurer perspective; societal perspective; sustainable return-to-work; Temporary agencies; temporary agency worker; Total costs; unemployed worker; Unemployment; Vocational rehabilitation; vulnerable worker population; worker without employment contract; Workers; Workplaces; Young Adult
• ISSN: 0355-3140; 1795-990X
• DOI: 10.5271/sjweh.3314

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 2—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 insurer'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.