Friedrich-Alexander University Erlangen-Nuremberg, Department of Clinical Psychology and Psychotherapy, Nägelsbachstrasse 25a, Erlangen, 91052, Germany.
Scand J Work Environ Health. 2018 Mar 1;44(2):171-182. doi: 10.5271/sjweh.3691. Epub 2017 Nov 16.
Objective This study aimed to estimate and evaluate the cost-effectiveness and cost-benefit of a guided internet- and mobile-supported occupational stress-management intervention (iSMI) for employees from the employer's perspective alongside a randomized controlled trial. Methods A sample of 264 employees with elevated symptoms of perceived stress (Perceived Stress Scale, PSS-10 ≥22) was randomly assigned either to the iSMI or a waitlist control (WLC) group with unrestricted access to treatment as usual. The iSMI consisted of seven sessions of problem-solving and emotion-regulation techniques and one booster session. Self-report data on symptoms of perceived stress and economic data were assessed at baseline, and at six months following randomization. A cost-benefit analysis (CBA) and a cost-effectiveness analysis (CEA) with symptom-free status as the main outcome from the employer's perspective was carried out. Statistical uncertainty was estimated using bootstrapping (N=5000). Results The CBA yielded a net-benefit of EUR181 [95% confidence interval (CI) -6043-1042] per participant within the first six months following randomization. CEA showed that at a willingness-to-pay ceiling of EUR0, EUR1000, EUR2000 for one additional symptom free employee yielded a 67%, 90%, and 98% probability, respectively, of the intervention being cost-effective compared to the WLC. Conclusion The iSMI was cost-effective when compared to WLC and even lead to cost savings within the first six months after randomization. Offering stress-management interventions can present good value for money in occupational healthcare.
目的 本研究旨在从雇主的角度，结合一项随机对照试验，估算和评估一种基于互联网和移动设备的职业压力管理干预措施（iSMI）对员工的成本效益和成本效益。
方法 随机抽取 264 名压力感症状升高（感知压力量表，PSS-10≥22）的员工样本，分为 iSMI 组或无限制接受常规治疗的等待名单对照组（WLC）。iSMI 由七节解决问题和情绪调节技术以及一节强化课程组成。在随机分组后，采用自我报告的感知压力症状数据和经济数据进行评估，分别在基线和随机分组后 6 个月进行评估。从雇主的角度进行成本效益分析（CBA）和成本效果分析（CEA），以无症状状态为主要结果。使用自举法（N=5000）估计统计不确定性。
结果 在随机分组后前 6 个月内，CBA 显示每位参与者的净收益为 181 欧元（95%置信区间（CI）-6043-1042）。CEA 显示，在愿意支付上限为 0 欧元、1000 欧元和 2000 欧元的情况下，每增加一名无症状员工，干预措施的成本效益比 WLC 分别有 67%、90%和 98%的可能性。
结论 与 WLC 相比，iSMI 具有成本效益，甚至在随机分组后前 6 个月内还能节省成本。在职业保健中提供压力管理干预措施可能具有良好的成本效益。
