Dewa Carolyn S, Hoch Jeffrey S
Head, Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, Toronto, Ontario; Senior Scientist and Health Economist, Centre for Addiction and Mental Health, Toronto, Ontario; Professor, Department of Psychiatry and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario.
Director, Centre for Excellence in Economic Analysis Research (CLEAR), St Michael's Hospital, Toronto, Ontario; Associate Professor, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario.
Can J Psychiatry. 2014 Oct;59(10 Suppl 1):S34-9. doi: 10.1177/070674371405901s08.
To explore basic requirements for a stigma program to produce sufficient savings to pay for itself (that is, break even).
A simple economic model was developed to compare reductions in total short-term disability (SDIS) cost relative to a stigma program's costs. A 2-way sensitivity analysis is used to illustrate conditions under which this break-even scenario occurs.
Using estimates from the literature for the SDIS costs, this analysis shows that a stigma program can provide value added even if there is no reduction in the length of an SDIS leave. To break even, a stigma program with no reduction in the length of an SDIS leave would need to prevent at least 2.5 SDIS claims in an organization of 1000 workers. Similarly, a stigma program can break even with no reduction in the number of SDIS claims if it is able to reduce SDIS episodes by at least 7 days in an organization of 1000 employees.
Modelling results, such as those presented in our paper, provide information to help occupational health payers become prudent buyers in the mental health market place. While in most cases, the required reductions seem modest, the real test of both the model and the program occurs once a stigma program is piloted and evaluated in a real-world setting.
探讨一个消除污名化项目产生足够储蓄以实现自给自足(即收支平衡)的基本要求。
开发一个简单的经济模型,以比较相对于消除污名化项目成本而言的短期残疾(SDIS)总成本的降低情况。采用双向敏感性分析来说明实现这种收支平衡情况的条件。
利用文献中关于SDIS成本的估计,该分析表明,即使SDIS假期时长没有减少,消除污名化项目也能提供附加值。为实现收支平衡,在一个有1000名员工的组织中,一个不减少SDIS假期时长的消除污名化项目需要至少防止2.5起SDIS索赔。同样,在一个有1000名员工的组织中,如果一个消除污名化项目能够将SDIS发作时长至少减少7天,那么即使SDIS索赔数量没有减少,该项目也能实现收支平衡。
如我们论文中所呈现的建模结果,为帮助职业健康支付方成为心理健康市场中的审慎购买者提供了信息。虽然在大多数情况下,所需的减少幅度似乎不大,但一旦在实际环境中对消除污名化项目进行试点和评估,该模型和项目才会面临真正的考验。