Department of Psychiatry and Psychotherapy II, University of Ulm and BKH Günzburg, Günzburg, Germany.
Department of Psychiatry and Psychotherapy of Technical, University of Munich, München, Germany.
Eur Psychiatry. 2023 Jul 24;66(1):e55. doi: 10.1192/j.eurpsy.2023.2427.
Only two-thirds of patients admitted to psychiatric wards return to their previous jobs. Return-to-work interventions in Germany are investigated for their effectiveness, but information regarding cost-effectiveness is lacking. This study investigates the cost-utility of a return-to-work intervention for patients with mental disorders compared to treatment as usual (TAU).
We used data from a cluster-randomised controlled trial including 166 patients from 28 inpatient psychiatric wards providing data at 6- and 12-month follow-ups. Health and social care service use was measured with the Client Sociodemographic and Service Receipt Inventory. Quality of life was measured with the EQ-5D-3L questionnaire. Cost-utility analysis was performed by calculating additional costs per one additional QALY (Quality-Adjusted Life Years) gained by receiving the support of return-to-work experts, in comparison to TAU.
No significant cost or QALY difference between the intervention and control groups has been detected. The return-to-work intervention cannot be identified as cost-effective in comparison to TAU.
The employment of return-to-work experts could not reach the threshold of providing good value for money. TAU, therefore, seems to be sufficient support for the target group.
仅有三分之二的精神科病房住院患者能够返回原工作岗位。德国目前正在研究工作回归干预措施的有效性，但缺乏有关成本效益的信息。本研究调查了与常规治疗（TAU）相比，针对精神障碍患者的工作回归干预措施的成本效益。
我们使用了一项包含 166 名来自 28 家提供 6 个月和 12 个月随访数据的住院精神病病房的患者的集群随机对照试验的数据。采用客户社会人口统计学和服务接受情况清单来衡量健康和社会保健服务的使用情况。采用 EQ-5D-3L 问卷来衡量生活质量。通过计算与 TAU 相比，接受工作回归专家支持所获得的每增加一个质量调整生命年（QALY）的额外成本，来进行成本-效用分析。
干预组和对照组之间未检测到成本或 QALY 的显著差异。与 TAU 相比，工作回归干预措施不能被认为是具有成本效益的。
雇佣工作回归专家的成本无法达到物有所值的门槛。因此，TAU 似乎足以满足目标群体的需求。
