Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium.
Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.
BMC Public Health. 2022 Jul 15;22(1):1362. doi: 10.1186/s12889-022-13659-y.
Decision makers want to know if there is a financial benefit in investing scarce resources in occupational health management (OHM). Economic evaluations (EEs) of OHM-strategies try to answer this question. However, EEs of OHM-strategies which are strongly marked by quantitative methods may be limited by contextual, qualitative residuals. Therefore, the objectives of this study were to (1) explore important economic dimensions of OHM and (2) to discuss the methods used in current EEs for measuring these dimensions.
In this explorative qualitative study, OHM-specialists were recruited via the Swiss organisation for health promotion. Thirteen semi-structured interviews were performed from November 2020 until May 2021. Videotapes were transcribed verbatim and organised by using an open coding strategy. Codes were clustered and synthesised as themes (i.e. the dimensions of EEs of OHM) through a mix of inductive and deductive content analysis. Member check with eight participants was accomplished to validate the results.
The interviews had an average duration of 70.5 min and yielded 609 individual codes. These codes were merged into 28 subcategories which were finally categorised into five main themes: Understanding of OHM, costs, benefits, environmental aspects, and evaluation of OHM. Participants stated that the greater part of costs and benefits cannot be quantified or monetised and thus, considered in quantitative EEs. For example, they see a culture of health as key component for a successful OHM-strategy. However, the costs to establish such a culture as well as its benefits are hard to quantify. Participants were highly critical of the use of absenteeism as a linear measure of productivity. Furthermore, they explained that single, rare events, such as a change in leadership, can have significant impact on employee health. However, such external influence factors are difficult to control.
Participants perceived costs and benefits of OHM significantly different than how they are represented in current EEs. According to the OHM-specialists, most benefits cannot be quantified and thus, monetised. These intangible benefits as well as critical influencing factors during the process should be assessed qualitatively and considered in EEs when using them as a legitimation basis vis-à-vis decision makers.
决策者想知道在职业健康管理（OHM）方面投入稀缺资源是否有经济上的好处。OHM 策略的经济评估（EE）试图回答这个问题。然而，以定量方法为主要特征的 OHM 策略 EE 可能受到情境、定性剩余的限制。因此，本研究的目的是（1）探讨 OHM 的重要经济维度，（2）讨论当前 EE 中用于衡量这些维度的方法。
在这项探索性定性研究中，通过瑞士健康促进组织招募了 OHM 专家。2020 年 11 月至 2021 年 5 月期间进行了 13 次半结构式访谈。录像带逐字转录，并通过开放式编码策略进行组织。通过归纳和演绎内容分析相结合的方法，将代码聚类并综合为主题（即 OHM EE 的维度）。用 8 名参与者进行成员检查以验证结果。
访谈平均持续 70.5 分钟，产生了 609 个单独的代码。这些代码合并为 28 个子类别，最终分为五个主要主题：对 OHM 的理解、成本、效益、环境方面和 OHM 的评估。参与者表示，大部分成本和效益无法量化或货币化，因此在定量 EE 中考虑。例如，他们认为健康文化是 OHM 策略成功的关键组成部分。然而，建立这种文化的成本及其效益很难量化。参与者对将旷工作为生产力的线性衡量标准表示强烈不满。此外，他们解释说，单一、罕见的事件，如领导层的变化，可能对员工的健康产生重大影响。然而，这些外部影响因素很难控制。
参与者对 OHM 的成本和效益的看法与当前 EE 中的代表方式有很大不同。根据 OHM 专家的说法，大多数效益无法量化，因此也无法货币化。这些无形效益以及在整个过程中具有关键影响的因素应进行定性评估，并在将其用作与决策者进行合法化的基础时在 EE 中考虑。
