Vocational Rehabilitation for Patients with Chronic Musculoskeletal Pain With or Without a Work Module: An Economic Eval
- PDF / 838,519 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 16 Downloads / 159 Views
Vocational Rehabilitation for Patients with Chronic Musculoskeletal Pain With or Without a Work Module: An Economic Evaluation Michiel F. Reneman1 · Timo T. Beemster2,3 · Sybren J. Welling4 · Jochen O. Mierau4,5 · Hermien H. Dijk4
© The Author(s) 2020
Abstract Purpose Vocational rehabilitation (VR) is a widely used intervention aimed to optimize work participation for patients on sick leave due to chronic musculoskeletal pain (CMP). Economic evaluations of care as usual VR are scarce, and may provide relevant information to guide clinical, reimbursement and policy decisions. The aim of this study was to evaluate the short-term cost-effectiveness and return on investment (ROI) of VR for patients on sick leave due to CMP with an additional work module (VR+) compared to VR without work module, from a societal and employers’ perspective. Methods A retrospective longitudinal cohort study within a Dutch care as usual context was applied. Participants with CMP and decreased work participation originating from seven Dutch rehabilitation centers were included in this study. Participants underwent VR or VR+. Main data sources at baseline and discharge: Quality-adjusted life year (QALY) based on EQ-5D, intervention costs, self-reported productivity and health care utilization. Main analyses cost-effectiveness, including incremental costeffectiveness ratio (ICER) and a cost-effectiveness acceptability curve (CEAC); and ROI analyses with use of the human capital method. Results N = 324 participants were analyzed. The results show that VR+ was cost-effective compared to VR: mean cost savings of €820 per 0.012 QALY gained. CEAC suggests probability of VR+ being cost-effective is > 0.91 for thresholds of €20.000 and higher. The mean ROI of VR+ for employers was 38%. Conclusion It was concluded that at discharge, VR+ was cost-effective compared to VR. ROI was positive for employers. Keywords Cost-effectiveness · Return on investment · QALY · ICER · CEAC · Chronic pain
Introduction
* Michiel F. Reneman [email protected] 1
Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Haren, P.O. Box 30.002, 9750 RA Groningen, The Netherlands
2
Department of Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands
3
Department Coronel Institute of Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
4
Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
5
Aletta Jacobs School of Public Health, University of Groningen, Groningen, The Netherlands
Chronic musculoskeletal pain (CMP) is one of the most frequent causes of work disability in the Netherlands [1]. Work disability places a large burden on both patients and on the Dutch economy through medical costs and work productivity costs which arise from impaired work participation: absenteeism and presenteeism [2–4]. Moreover, the economic burden of CMP in The Netherlands was estimated at €3.5
Data Loading...
