Author:
Tingulstad Alexander,Maas Esther T.,Rysstad Tarjei,Øiestad Britt Elin,Aanesen Fiona,Pripp Are Hugo,Van Tulder Maurits W.,Grotle Margreth
Abstract
Abstract
Objectives
This study evaluates the six-month cost-effectiveness and cost-benefits of motivational interviewing (MI) or a stratified vocational advice intervention (SVAI) added to usual case management (UC) for workers on sick leave due to musculoskeletal disorders.
Methods
This study was conducted alongside a three-arm RCT including 514 employed workers on sick leave for at least 50% for ≥ 7 weeks. All participants received UC. The UC + MI group received two MI sessions, and the UC + SVAI group received 1–4 SVAI sessions. Sickness absence days, quality-adjusted life-years (QALYs), and societal costs were measured between baseline and six months.
Results
Adding MI to UC, resulted in incremental cost-reduction of -2580EUR (95%CI -5687;612), and a reduction in QALYs of -0.001 (95%CI -0.02;0.01). Secondly, adding MI to UC resulted in an incremental cost-reduction of -538EUR (95%CI -1358;352), and reduction of 5.08 (95%CI -3.3;13.5) sickness-absence days. Financial return estimates were positive, but not statistically significant. Adding SVAI to UC, resulted in an incremental cost-reduction of -2899 EUR (95% CI -5840;18), and a reduction in QALYs of 0.002 (95% CI -0.02;0.01). Secondly, adding SVAI to UC resulted in an statistically significant incremental cost-reduction of -695 EUR (95% CI -1459;-3), and a reduction of 7.9 (95% CI -0.04;15.9) sickness absence days. Financial return estimates were positive and statistically significant. The probabilities of cost-effectiveness for QALYs were high for adding MI or SVAI (ceiling ratio 0.90).
Conclusions
In comparison to UC only, adding MI to UC tends to be cost-effective. Adding SVAI to UC is cost-effective for workers on sick leave due to musculoskeletal disorders.
Trial registration
ClinicalTrials.gov (identifier: NCT03871712).
Funder
The Research Council of Norway
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,Safety Research,Toxicology
Reference32 articles.
1. Vos T, Lim SS, Abbafati C, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of disease study 2019. The Lancet. 2020;396(10258):1204–22.
2. Kinge JM, Sælensminde K, Dieleman J, Vollset SE, Norheim OF. Economic losses and burden of disease by medical conditions in Norway. Health Policy. 2017;121(6):691–8.
3. Bevan S. Economic impact of musculoskeletal disorders (MSDs) on work in Europe. Best Pract Res Clin Rheumatol. 2015;29(3):356–73.
4. De Kok J, Vroonhof P, Snijders J, et al. (2019). Work-related musculoskeletal disorders: prevalence, costs and demographics in the EU. European agency for safety and health at work. 2019.
5. Waddell G, Burton AK. Is work good for your health and well-being? London: TSO; 2006.