Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium.
Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.
Eur J Public Health. 2019 Jun 1;29(3):540-546. doi: 10.1093/eurpub/cky269.
The aim of this study was to assess the evidence regarding economic evaluations of worksite health promotion programs in Europe.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the literature search, study selection, data extraction and quality appraisal were performed independently by two researchers. Full economic evaluations of worksite health promotion programs carried out in a European workplace were included.
From 1728 search results, 39 articles describing 37 studies were included. Regarding methodological quality, 9 studies were rated as strong, 15 as moderate and 15 as weak. Six of the studies fulfilled the minimum standard for health economic evaluations. Worksite health promotion was applied in many different forms for a wide range of settings. Cost-effectiveness, cost-benefit and cost-utility analyses were performed from different perspectives. Effects on health outcomes tended to be small and uncertain. Only 9 out of 21 cost-benefit analyses reported a financial benefit and 10 out of 23 cost-effectiveness analyses concluded that the intervention was cost-effective. Two out of eight cost-utility analyses were found to be cost-effective. Productivity loss accounted for more than 85% of the total costs and thus, was the main cost driver in the analyses.
Due to considerable heterogeneity, no specific type of intervention could be identified to be particularly effective and the economic value of worksite health promotion remains uncertain. Further studies, investigating comprehensive worksite health promotion programs are needed to provide evidence on their efficiency. Guidelines to perform economic evaluations in the field of worksite health promotion, especially for valuation of productivity loss, are required.
本研究旨在评估欧洲工作场所健康促进计划的经济评估证据。
根据系统评价和荟萃分析的首选报告项目指南，两名研究人员独立进行文献搜索、研究选择、数据提取和质量评估。纳入了在欧洲工作场所进行的完整的工作场所健康促进计划的经济评估。
从 1728 个搜索结果中，有 39 篇文章描述了 37 项研究被纳入。关于方法学质量，9 项研究被评为强，15 项为中，15 项为弱。6 项研究符合健康经济评估的最低标准。工作场所健康促进以多种不同形式应用于广泛的环境中。从不同角度进行了成本效益、成本效益和成本效用分析。对健康结果的影响往往较小且不确定。在 21 项成本效益分析中，仅有 9 项报告了财务效益，在 23 项成本效益分析中，有 10 项得出干预措施具有成本效益的结论。在 8 项成本效用分析中，有 2 项被认为具有成本效益。生产力损失占总成本的 85%以上，因此是分析中的主要成本驱动因素。
由于存在很大的异质性，无法确定哪种特定类型的干预措施特别有效，工作场所健康促进的经济价值仍然不确定。需要进一步的研究来提供关于其效率的证据，调查全面的工作场所健康促进计划。需要制定在工作场所健康促进领域进行经济评估的指南，特别是针对生产力损失的评估。
