Title
Economic evaluation of a multi-stage return to work program for workers on sick-leave due to low back pain
Author
Steenstra, I.A.
Anema, J.R.
van Tulder, M.W.
Bongers, P.M.
de Vet, H.C.W.
van Mechelen, W.
TNO Kwaliteit van Leven
Publication year
2006
Abstract
Objective: To evaluate the cost-effectiveness and cost-utility of a return to work (RTW) program for workers on sick-leave due to low back pain (LBP), comparing a workplace intervention implemented between 2 to 8 weeks of sick-leave with usual care, and a clinical intervention after 8 weeks of sick-leave with usual care. Design: Economic evaluation alongside a randomised controlled trial (RCT). Study population: Workers sick-listed for a period of 2 to 6 weeks due to LBP. Interventions: 1. workplace assessment, work modifications and case management). 2. physiotherapy based on operant behavioural principles. 3. usual care: provided by an occupational physician. Outcomes: The primary outcome was return to work (RTW). Other outcomes were pain intensity, functional status, quality of life and general health. The economic evaluation was conducted from a societal perspective. Outcomes were assessed at baseline (after 2-6 weeks on sick-leave), and 12 weeks, 26 weeks, and 52 weeks after the first day of sick-leave. Results: The workplace intervention group returned to work 30.0 days (95% CI=[3.1, 51.3]) earlier on average than the usual care group at slightly higher direct costs (ratio of 1 day: €19). Workers in the clinical intervention group that had received usual care in the first 8 weeks returned to work 21.3 days (95% CI= [-74.1, 29.2]) later on average. The group that had received the workplace intervention in the first 8 weeks and the clinical intervention after 8 weeks returned to work 50.9 days (95% CI=[-89.4, -2.7]) later on average. A workplace intervention was more effective than usual care in RTW at slightly higher costs and was equally effective as usual care at equal costs on other outcomes. A clinical intervention was less effective than usual care and associated with higher costs. Conclusion: The workplace intervention results in a safe and faster RTW than usual care at reasonable costs for workers on sick-leave for two to six weeks due to LBP. © 2006 Springer Science+Business Media, LLC.
Subject
Workplace
Veilig en Gezond Werken
Cost-effectiveness
Occupational health
Operant behavioural
Participative Ergonomics
Randomized Controlled Trial
Return to work
Clinical trial
Comparative study
Controlled clinical trial
Controlled study
Cost effectiveness analysis
Cost utility analysis
Economic evaluation
Functional assessment
Health status
Instrumental conditioning
Major clinical study
Medical leave
Occupational physician
Pain assessment
Patient care
Physiotherapy
Quality of life
Randomized controlled trial
Safety
Social aspect
Treatment outcome
Work resumption
Workplace
Adolescent
Adult
Aged
Behavior Therapy
Cost of Illness
Cost-Benefit Analysis
Female
Health Care Costs
Human Engineering
Humans
Low Back Pain
Male
Middle Aged
Netherlands
Occupational Diseases
Occupational Health Nursing
Occupational Therapy
Rehabilitation, Vocational
To reference this document use:
http://resolver.tudelft.nl/uuid:b967c1ff-d858-4017-8c98-4fae15b4120c
DOI
https://doi.org/10.1007/s10926-006-9053-0
TNO identifier
239624
ISSN
1053-0487
Source
Journal of Occupational Rehabilitation, 16 (4), 557-578
Document type
article