Cost-Effectiveness of Guideline-Based Care for Workers with Mental Health Problems

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 ((sic)574.532 in total) were lower in the intervention group (mean difference -(sic)520; 95% CI-(sic)980 to (sic)59), 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. (J Occup Environ Med. 2009;51:313-322)