The cost-utility of a return-to-work intervention in comparison to routine care for patients with mental disorders in Germany: Results from the RETURN project.
cost-utility analysis
mental disorder
mental health
return-to-work
Journal
European psychiatry : the journal of the Association of European Psychiatrists
ISSN: 1778-3585
Titre abrégé: Eur Psychiatry
Pays: England
ID NLM: 9111820
Informations de publication
Date de publication:
24 07 2023
24 07 2023
Historique:
medline:
11
9
2023
pubmed:
24
7
2023
entrez:
24
7
2023
Statut:
epublish
Résumé
Only two-thirds of patients admitted to psychiatric wards return to their previous jobs. Return-to-work interventions in Germany are investigated for their effectiveness, but information regarding cost-effectiveness is lacking. This study investigates the cost-utility of a return-to-work intervention for patients with mental disorders compared to treatment as usual (TAU). We used data from a cluster-randomised controlled trial including 166 patients from 28 inpatient psychiatric wards providing data at 6- and 12-month follow-ups. Health and social care service use was measured with the Client Sociodemographic and Service Receipt Inventory. Quality of life was measured with the EQ-5D-3L questionnaire. Cost-utility analysis was performed by calculating additional costs per one additional QALY (Quality-Adjusted Life Years) gained by receiving the support of return-to-work experts, in comparison to TAU. No significant cost or QALY difference between the intervention and control groups has been detected. The return-to-work intervention cannot be identified as cost-effective in comparison to TAU. The employment of return-to-work experts could not reach the threshold of providing good value for money. TAU, therefore, seems to be sufficient support for the target group.
Sections du résumé
BACKGROUND
Only two-thirds of patients admitted to psychiatric wards return to their previous jobs. Return-to-work interventions in Germany are investigated for their effectiveness, but information regarding cost-effectiveness is lacking. This study investigates the cost-utility of a return-to-work intervention for patients with mental disorders compared to treatment as usual (TAU).
METHODS
We used data from a cluster-randomised controlled trial including 166 patients from 28 inpatient psychiatric wards providing data at 6- and 12-month follow-ups. Health and social care service use was measured with the Client Sociodemographic and Service Receipt Inventory. Quality of life was measured with the EQ-5D-3L questionnaire. Cost-utility analysis was performed by calculating additional costs per one additional QALY (Quality-Adjusted Life Years) gained by receiving the support of return-to-work experts, in comparison to TAU.
RESULTS
No significant cost or QALY difference between the intervention and control groups has been detected. The return-to-work intervention cannot be identified as cost-effective in comparison to TAU.
CONCLUSIONS
The employment of return-to-work experts could not reach the threshold of providing good value for money. TAU, therefore, seems to be sufficient support for the target group.
Identifiants
pubmed: 37486071
doi: 10.1192/j.eurpsy.2023.2427
pii: S0924933823024276
pmc: PMC10486254
doi:
Types de publication
Randomized Controlled Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e55Références
Eur Psychiatry. 2023 Jan 09;66(1):e9
pubmed: 36621009
J Health Soc Behav. 2001 Jun;42(2):132-50
pubmed: 11467249
Br J Psychiatry Suppl. 2000;(39):s28-33
pubmed: 10945075
J Occup Health Psychol. 2015 Apr;20(2):248-58
pubmed: 25402222
Health Psychol. 1999 Sep;18(5):495-505
pubmed: 10519466
N Engl J Med. 2017 Jan 19;376(3):203-205
pubmed: 28099837
BMC Psychiatry. 2020 Apr 19;20(1):177
pubmed: 32306925
J Occup Rehabil. 2022 Mar;32(1):114-127
pubmed: 34050882
Int J Environ Res Public Health. 2020 Jul 20;17(14):
pubmed: 32698470
J Occup Rehabil. 2018 Mar;28(1):1-15
pubmed: 28224415
Schizophr Bull. 2002;28(2):249-57
pubmed: 12693431
Schizophr Bull. 1998;24(3):469-77
pubmed: 9718638
Eur Psychiatry. 2022 Aug 19;65(1):e51
pubmed: 35983840
Psychol Med. 1998 May;28(3):551-8
pubmed: 9626712
Cochrane Database Syst Rev. 2020 Oct 13;10:CD006237
pubmed: 33052607
J Occup Rehabil. 2021 Sep;31(3):604-612
pubmed: 33492634
BMC Public Health. 2015 Aug 19;15:796
pubmed: 26286039
J Med Econ. 2022 Jan;25(sup1):1-7
pubmed: 35012427
Disabil Rehabil. 2005 Aug 5;27(15):891-900
pubmed: 16096241
Gesundheitswesen. 2023 Apr;85(4):298-304
pubmed: 34921361
Arch Gen Psychiatry. 1980 Apr;37(4):392-7
pubmed: 7362425
J Occup Rehabil. 2010 Mar;20(1):104-12
pubmed: 19894106
Occup Environ Med. 2010 Sep;67(9):603-10
pubmed: 20798027
Psychiatr Prax. 2001 Oct;28 Suppl 2:S84-90
pubmed: 11605129
Psychiatr Prax. 2007 Jul;34(5):246-8
pubmed: 18217220
Occup Environ Med. 2012 Nov;69(11):837-45
pubmed: 22864248
J Behav Health Serv Res. 2016 Apr;43(2):155-71
pubmed: 24504832
Psychiatr Prax. 2021 Apr;48(3):119-126
pubmed: 33271622
J Rehabil Med. 2021 Jan 13;53(1):jrm00146
pubmed: 33393638
Arch Gen Psychiatry. 1973 Oct;29(4):505-11
pubmed: 4748311
SSM Popul Health. 2016 Jun 09;2:407-415
pubmed: 29349158
J Public Health Res. 2021 Oct 07;11(1):
pubmed: 34619858
Healthc Pap. 2004;5(2):100-11
pubmed: 15829771
Eur J Health Econ. 2005 Jun;6(2):124-30
pubmed: 19787848
Psychiatr Prax. 2018 May;45(4):197-205
pubmed: 28499318
Psychosomatics. 1995 May-Jun;36(3):267-75
pubmed: 7638314