School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.
BMC Public Health. 2012 Jan 18;12:43. doi: 10.1186/1471-2458-12-43.
In the Netherlands, absenteeism and reduced productivity due to work disability lead to high yearly costs reaching almost 5% of the gross national product. To reduce the economic burden of sick leave and reduced productivity, different employability interventions for work-disabled employees or employees at risk of work disability have been developed. Within this study, called 'CASE-study' (Cost-effectiveness Analysis of Sustainable Employability), five different employability interventions directed at work disabled employees with divergent health complaints will be analysed on their effectiveness and cost-effectiveness. This paper describes a consistent and transparent methodological design to do so.
METHODS/DESIGN: Per employability intervention 142 participants are needed whereof approximately 66 participants receiving the intervention will be compared with 66 participants receiving usual care. Based on the intervention-specific characteristics, a randomized control trial or a quasi-experiment with match-criteria will be conducted. Notwithstanding the study design, eligible participants will be employees aged 18 to 63, working at least 12 h per week, and at risk of work disability, or already work-disabled due to medical restrictions. The primary outcome will be the duration of sick leave. Secondary outcomes are health status and quality of life. Outcomes will be assessed at baseline and then 6, 12 and 18 months later. Economic costs will consist of healthcare costs and cost of lost production due to work disability, and will be evaluated from a societal perspective.
The CASE-study is the first to conduct economic evaluations of multiple different employability interventions based on a similar methodological framework. The cost-effectiveness results for every employability intervention will be published in 2014, but the methods, strengths and weaknesses of the study protocol are discussed in this paper. To contribute to treatment options in occupational health practice and enable the development of guidelines on how to conduct economic evaluation better suited to this field; this paper provides an important first step.
Four trials involved in the CASE-study are registered with the Netherlands Trial Registry: Care for Work (NTR2886), Health and Motion (NTR3111), Guidance to Excel in Return to Work (NTR3151), Care for Companies/Second Care (NTR3136).
在荷兰，因工作残疾导致的旷工和生产力下降造成了每年近 5%的国民生产总值的高损失。为了降低病假和生产力下降造成的经济负担，已经为工作残疾或有工作残疾风险的员工开发了不同的就业能力干预措施。在这项名为“案例研究”（可持续就业的成本效益分析）的研究中，将对针对具有不同健康问题的工作残疾员工的五种不同就业能力干预措施进行有效性和成本效益分析。本文介绍了一种一致和透明的方法设计。
方法/设计：每个就业能力干预措施需要 142 名参与者，其中大约 66 名接受干预的参与者将与 66 名接受常规护理的参与者进行比较。根据干预措施的具体特点，将进行随机对照试验或具有匹配标准的准实验。尽管研究设计不同，但符合条件的参与者将是年龄在 18 至 63 岁之间、每周至少工作 12 小时、有工作残疾风险或因医疗限制而已经工作残疾的员工。主要结果将是病假持续时间。次要结果是健康状况和生活质量。结果将在基线时进行评估，然后在 6、12 和 18 个月后进行评估。经济成本将包括因工作残疾而导致的医疗保健成本和生产损失成本，并将从社会角度进行评估。
案例研究是第一个基于类似方法框架对多种不同就业能力干预措施进行经济评估的研究。2014 年将公布每个就业能力干预措施的成本效益结果，但本文将讨论研究方案的方法、优势和劣势。为了为职业健康实践中的治疗选择做出贡献，并使制定更适合该领域的经济评估指南成为可能；本文提供了一个重要的第一步。
案例研究中涉及的四项试验已在荷兰试验注册中心注册：Care for Work（NTR2886）、Health and Motion（NTR3111）、Guidance to Excel in Return to Work（NTR3151）、Care for Companies/Second Care（NTR3136）。
