The effects of timing on the cost-effectiveness of interventions for workers on sick leave due to low back pain

M van Duijn, M Eijkemans, B Koes, M Koopmanschap , Anthony Burton, A Burdorf

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Objective To examine the effects of different timing of structured interventions for workers on sick leave due to low back pain on return to work (RTW), and the consequences for costs and benefits.

Methods Literature reviews were conducted to identify RTW curves and to estimate treatment effects, costs and benefits of structured interventions among workers on sick leave due to low back pain. RTW curves were mathematically described by Weibull functions and intervention effects, expressed by hazard ratios, were used to adjust these Weibull functions. Subsequently, these functions were used to evaluate the theoretical effects of interventions on reduction in number of days on sick leave and on the benefit–cost ratio.

Results The cost-benefits of a RTW intervention among workers on sick leave due to low back pain were determined by the estimated effectiveness of the intervention, the costs of the intervention, the natural course of RTW in the target population, the timing of the enrolment of subjects into the intervention, and the duration of the intervention.

Conclusion With a good RTW in the first weeks, the only early interventions likely to be cost-beneficial are inexpensive work-focused enhancements to early routine care, such as accommodating workplaces. Structured interventions are unlikely to have an additional impact on the already good prognosis when offered before the optimal time window at approximately 8 to 12 weeks. The generalisibility of the effectiveness of a RTW intervention depends on the comparability of baseline characteristics and RTW curves in target and source populations.
Original languageEnglish
Pages (from-to)744-750
Number of pages7
JournalOccupational and Environmental Medicine
Volume67
Issue number11
Early online date19 Oct 2010
DOIs
Publication statusPublished - 1 Nov 2010

Fingerprint

Sick Leave
Return to Work
Low Back Pain
Cost-Benefit Analysis
Health Services Needs and Demand
Workplace
Health Care Costs
Costs and Cost Analysis

Cite this

van Duijn, M ; Eijkemans, M ; Koes, B ; Koopmanschap , M ; Burton, Anthony ; Burdorf, A. / The effects of timing on the cost-effectiveness of interventions for workers on sick leave due to low back pain. In: Occupational and Environmental Medicine. 2010 ; Vol. 67, No. 11. pp. 744-750.
@article{18a1698ed1f14d878909d3bd63be8d4f,
title = "The effects of timing on the cost-effectiveness of interventions for workers on sick leave due to low back pain",
abstract = "Objective To examine the effects of different timing of structured interventions for workers on sick leave due to low back pain on return to work (RTW), and the consequences for costs and benefits.Methods Literature reviews were conducted to identify RTW curves and to estimate treatment effects, costs and benefits of structured interventions among workers on sick leave due to low back pain. RTW curves were mathematically described by Weibull functions and intervention effects, expressed by hazard ratios, were used to adjust these Weibull functions. Subsequently, these functions were used to evaluate the theoretical effects of interventions on reduction in number of days on sick leave and on the benefit–cost ratio.Results The cost-benefits of a RTW intervention among workers on sick leave due to low back pain were determined by the estimated effectiveness of the intervention, the costs of the intervention, the natural course of RTW in the target population, the timing of the enrolment of subjects into the intervention, and the duration of the intervention.Conclusion With a good RTW in the first weeks, the only early interventions likely to be cost-beneficial are inexpensive work-focused enhancements to early routine care, such as accommodating workplaces. Structured interventions are unlikely to have an additional impact on the already good prognosis when offered before the optimal time window at approximately 8 to 12 weeks. The generalisibility of the effectiveness of a RTW intervention depends on the comparability of baseline characteristics and RTW curves in target and source populations.",
author = "{van Duijn}, M and M Eijkemans and B Koes and M Koopmanschap and Anthony Burton and A Burdorf",
year = "2010",
month = "11",
day = "1",
doi = "10.1136/oem.2009.049874",
language = "English",
volume = "67",
pages = "744--750",
journal = "Occupational and Environmental Medicine",
issn = "1351-0711",
publisher = "BMJ Publishing Group",
number = "11",

}

The effects of timing on the cost-effectiveness of interventions for workers on sick leave due to low back pain. / van Duijn, M; Eijkemans, M; Koes, B; Koopmanschap , M; Burton, Anthony; Burdorf, A.

In: Occupational and Environmental Medicine, Vol. 67, No. 11, 01.11.2010, p. 744-750.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The effects of timing on the cost-effectiveness of interventions for workers on sick leave due to low back pain

AU - van Duijn, M

AU - Eijkemans, M

AU - Koes, B

AU - Koopmanschap , M

AU - Burton, Anthony

AU - Burdorf, A

PY - 2010/11/1

Y1 - 2010/11/1

N2 - Objective To examine the effects of different timing of structured interventions for workers on sick leave due to low back pain on return to work (RTW), and the consequences for costs and benefits.Methods Literature reviews were conducted to identify RTW curves and to estimate treatment effects, costs and benefits of structured interventions among workers on sick leave due to low back pain. RTW curves were mathematically described by Weibull functions and intervention effects, expressed by hazard ratios, were used to adjust these Weibull functions. Subsequently, these functions were used to evaluate the theoretical effects of interventions on reduction in number of days on sick leave and on the benefit–cost ratio.Results The cost-benefits of a RTW intervention among workers on sick leave due to low back pain were determined by the estimated effectiveness of the intervention, the costs of the intervention, the natural course of RTW in the target population, the timing of the enrolment of subjects into the intervention, and the duration of the intervention.Conclusion With a good RTW in the first weeks, the only early interventions likely to be cost-beneficial are inexpensive work-focused enhancements to early routine care, such as accommodating workplaces. Structured interventions are unlikely to have an additional impact on the already good prognosis when offered before the optimal time window at approximately 8 to 12 weeks. The generalisibility of the effectiveness of a RTW intervention depends on the comparability of baseline characteristics and RTW curves in target and source populations.

AB - Objective To examine the effects of different timing of structured interventions for workers on sick leave due to low back pain on return to work (RTW), and the consequences for costs and benefits.Methods Literature reviews were conducted to identify RTW curves and to estimate treatment effects, costs and benefits of structured interventions among workers on sick leave due to low back pain. RTW curves were mathematically described by Weibull functions and intervention effects, expressed by hazard ratios, were used to adjust these Weibull functions. Subsequently, these functions were used to evaluate the theoretical effects of interventions on reduction in number of days on sick leave and on the benefit–cost ratio.Results The cost-benefits of a RTW intervention among workers on sick leave due to low back pain were determined by the estimated effectiveness of the intervention, the costs of the intervention, the natural course of RTW in the target population, the timing of the enrolment of subjects into the intervention, and the duration of the intervention.Conclusion With a good RTW in the first weeks, the only early interventions likely to be cost-beneficial are inexpensive work-focused enhancements to early routine care, such as accommodating workplaces. Structured interventions are unlikely to have an additional impact on the already good prognosis when offered before the optimal time window at approximately 8 to 12 weeks. The generalisibility of the effectiveness of a RTW intervention depends on the comparability of baseline characteristics and RTW curves in target and source populations.

U2 - 10.1136/oem.2009.049874

DO - 10.1136/oem.2009.049874

M3 - Article

VL - 67

SP - 744

EP - 750

JO - Occupational and Environmental Medicine

JF - Occupational and Environmental Medicine

SN - 1351-0711

IS - 11

ER -