The School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.
J Public Health (Oxf). 2012 Mar;34(1):115-24. doi: 10.1093/pubmed/fdr057. Epub 2011 Aug 16.
Sickness absence costs the UK economy around £20 billion per year. This study aims to assess the cost-effectiveness of interventions to return employees with musculoskeletal disorders to work, one of the major causes of long-term sickness absence, using a mathematical model.
A Markov model was developed to assess the cost-effectiveness of three interventions: a workplace intervention; a physical activity and education intervention and a physical activity, education and workplace visit intervention. Extensive sensitivity analyses were undertaken to assess the impact of uncertainties upon the model results.
All interventions assessed are estimated to have a cost per quality-adjusted life year gained below £3000 compared with usual care within the UK from a National Health Service (NHS) or societal perspective. Moreover, any intervention which returns at least an additional 3% of employees to work and costs less than an additional £3000 per employee, is likely to be considered economically attractive compared with usual care, relative to other interventions routinely funded by the NHS.
This is the first economic evaluation in this area which extrapolates data beyond trial follow-up and synthesizes evidence from numerous sources. This sort of modelling approach should be considered for informing other public health policy decisions.
英国每年因员工患病缺勤而损失约 200 亿英镑。本研究旨在使用数学模型评估干预措施对返回患有肌肉骨骼疾病员工的成本效益，这些干预措施是导致长期患病缺勤的主要原因之一。
开发了一个马尔可夫模型来评估三种干预措施的成本效益：工作场所干预、身体活动和教育干预以及身体活动、教育和工作场所访问干预。进行了广泛的敏感性分析，以评估不确定性对模型结果的影响。
从英国国民保健制度（NHS）或社会角度来看，与常规护理相比，所有评估的干预措施都预计每获得一个质量调整生命年的成本低于 3000 英镑。此外，任何能够使至少额外 3%的员工返回工作岗位且每个员工的成本低于 3000 英镑的干预措施，与 NHS 常规资助的其他干预措施相比，都可能被认为具有成本效益。
这是该领域的首次经济评估，它将数据外推到试验随访之外，并综合了来自多个来源的证据。这种建模方法应考虑用于为其他公共卫生政策决策提供信息。
