Leuven Institute for Healthcare Policy, KU Leuven, 3000 Leuven, Belgium.
Environment and Health, KU Leuven, 3000 Leuven, Belgium.
Int J Environ Res Public Health. 2018 Nov 21;15(11):2606. doi: 10.3390/ijerph15112606.
An emerging issue in occupational health and safety (OHS) is that interventions increasingly have to demonstrate that they offer sufficient value for money. To this end, the last decennia have seen more and more economic evaluation methods being employed in this field. However, several recent publications have indicated that many of the published studies suffer from important shortcomings. This paper aims to highlight difficulties in assessing the value of OHS by use of current economic evaluation methods. First, a summary framework presents an overview of the costs and benefits relevant for OHS interventions. Next, three elements from this framework are selected that are at the same time crucial to OHS value, but also challenging to measure and monetise: Effects on worker productivity, 'intangible' benefits, such as reputation effects, and the influence of the broader legal⁻fiscal context in which an intervention takes place. The following sections then discuss the following research questions for each of these elements: Why is it difficult to exclude these factors from OHS economic evaluations? Why do they pose a challenge to the quality of economic evaluations in OHS? How can they be included, and what are the known advantages and disadvantages of the methods to measure these factors? Future work should investigate (and standardise) better methods to include these elements.
职业健康与安全（OHS）领域出现的一个新问题是，干预措施必须越来越多地证明其具有足够的成本效益。为此，过去几十年在该领域越来越多地采用了更多的经济评估方法。然而，最近的几项研究表明，许多已发表的研究存在重要的缺陷。本文旨在强调使用当前经济评估方法评估 OHS 价值的困难。首先，一个总结框架概述了与 OHS 干预措施相关的成本和收益。其次，从该框架中选择了三个同时对 OHS 价值至关重要但难以衡量和货币化的元素：对工人生产力的影响、“无形”效益，例如声誉效应，以及干预措施发生的更广泛法律⁻财政背景的影响。接下来的几个部分分别针对这些要素中的每一个探讨了以下研究问题：为什么很难将这些因素排除在 OHS 经济评估之外？为什么它们对 OHS 经济评估的质量构成挑战？如何将它们包括在内，以及衡量这些因素的方法的已知优缺点是什么？未来的工作应该研究（并标准化）更好的方法来纳入这些要素。
