Cost-effectiveness of guideline-based care for workers with mental health problems

J Occup Environ Med. 2009 Mar;51(3):313-22. doi: 10.1097/JOM.0b013e3181990d8e.


Objective: To evaluate the cost-effectiveness of an activating guideline-based care (GBC) by occupational physicians (OPs).

Methods: An economic evaluation was conducted in a randomized controlled trial with police workers on sick leave due to mental health problems (n = 240). In the intervention group trained OPs provided GBC, compared with usual care with easy access to a psychologist. Sick leave data and health care costs were gathered after 1-year follow-up. Analyses comprised bootstrap techniques, cost-effectiveness planes, and acceptability curves.

Results: Health care utilization costs (euro574.532 in total) were significantly lower in the intervention group (mean difference -euro520; 95% CI -euro980 to euro59), whereas there were no significant differences in days of sick leave and productivity loss costs.

Conclusions: GBC could be cost-effective, as lower direct costs lead to equal treatment outcomes of workers with common mental disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cost-Benefit Analysis
  • Efficiency
  • Female
  • Guidelines as Topic
  • Health Services / economics
  • Health Services / statistics & numerical data
  • Health Services Accessibility
  • Humans
  • Male
  • Mental Disorders / therapy*
  • Middle Aged
  • Occupational Health*
  • Practice Guidelines as Topic
  • Randomized Controlled Trials as Topic
  • Sick Leave