Lo Sasso Anthony T, Rost Kathryn, Beck Arne
Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, IL 60612, USA.
Med Care. 2006 Apr;44(4):352-8. doi: 10.1097/01.mlr.0000204049.30620.1e.
The impact of depression on the workplace has been widely observed in studies examining absenteeism and reduced productivity during days at work. However, there is little scientific evidence about whether depression interventions are cost-beneficial to employers.
We construct a cost-benefit analysis of depression treatment under different workplace assumptions better reflecting the nature of employment.
Data from a randomized controlled trial in which employed primary care patients with depression were treated in practices randomly assigned to an enhanced treatment intervention or usual care were used to construct a cost-benefit model from an employer perspective under different assumptions regarding employment.
A national sample of 198 workers employed in a range of positions by companies was studied.
Benefits included self-reported productivity and absenteeism; costs included intervention and treatment costs. Net benefit was calculated under different scenarios and return on investment (ROI) is derived.
Enhanced depression treatment resulted in an average net benefit to the employer of Dollars 30 per participating worker in Year 1 of the intervention and Dollars 257 per participating worker in Year 2, for an estimated ROI during the 2-year period of 302%. ROI increased in firms that rely on team production, hire more costly substitute labor, or realize penalties for output shortfalls. ROI decreased in firms that have a large fraction of employees with dependent coverage and experience high turnover rates. Results also are sensitive to how subjectively reported productivity is valued.
Many employers will receive a potentially significant ROI from depression treatment models that improve absenteeism and productivity at work.
在研究旷工和工作期间生产力下降的过程中，抑郁症对工作场所的影响已被广泛观察到。然而，关于抑郁症干预措施对雇主是否具有成本效益，几乎没有科学证据。
我们构建了一个在不同工作场所假设下对抑郁症治疗的成本效益分析，以更好地反映就业的本质。
一项随机对照试验的数据，该试验中患有抑郁症的在职初级保健患者在被随机分配到强化治疗干预组或常规治疗组的医疗机构接受治疗，我们从雇主的角度在不同的就业假设下使用这些数据构建了一个成本效益模型。
对来自各公司一系列职位的198名员工的全国样本进行了研究。
效益包括自我报告的生产力和旷工情况；成本包括干预和治疗成本。在不同情景下计算净效益并得出投资回报率（ROI）。
强化抑郁症治疗在干预的第1年为每位参与治疗的员工给雇主带来平均30美元的净效益，在第2年为每位参与治疗的员工带来257美元的净效益，在两年期间估计的投资回报率为302%。在依赖团队生产、雇佣成本更高的替代劳动力或因产量不足而受到处罚的公司中，投资回报率会增加。在有很大一部分员工享受家属保险且员工流动率高的公司中，投资回报率会下降。结果还对主观报告的生产力的估值方式敏感。
许多雇主将从改善旷工和工作生产力的抑郁症治疗模式中获得潜在的显著投资回报率。
