Rebergen D S, Bruinvels D J, van Tulder M W, van der Beek A J, van Mechelen W
Department of Public and Occupational Health, EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands.
J Occup Environ Med. 2009 Mar;51(3):313-22. doi: 10.1097/JOM.0b013e3181990d8e.
To evaluate the cost-effectiveness of an activating guideline-based care (GBC) by occupational physicians (OPs).
An economic evaluation was conducted in a randomized controlled trial with police workers on sick leave due to mental health problems (n = 240). In the intervention group trained OPs provided GBC, compared with usual care with easy access to a psychologist. Sick leave data and health care costs were gathered after 1-year follow-up. Analyses comprised bootstrap techniques, cost-effectiveness planes, and acceptability curves.
Health care utilization costs (euro574.532 in total) were significantly lower in the intervention group (mean difference -euro520; 95% CI -euro980 to euro59), whereas there were no significant differences in days of sick leave and productivity loss costs.
GBC could be cost-effective, as lower direct costs lead to equal treatment outcomes of workers with common mental disorders.
评估职业医师基于指南的激活式护理（GBC）的成本效益。
在一项针对因心理健康问题休病假的警察工作人员（n = 240）的随机对照试验中进行了经济评估。干预组由经过培训的职业医师提供GBC，与可轻松获得心理学家服务的常规护理进行比较。在1年随访后收集病假数据和医疗保健成本。分析包括自助法技术、成本效益平面和可接受性曲线。
干预组的医疗保健利用成本（总计574532欧元）显著更低（平均差异为-520欧元；95%置信区间为-980欧元至59欧元），而病假天数和生产力损失成本无显著差异。
GBC可能具有成本效益，因为较低的直接成本可带来常见精神障碍工人同等的治疗效果。
