Protecting and promoting mental health of nurses in the hospital setting: Is it cost-effective from an employer’s perspective?

Abstract

Objectives: Nurses are at elevated risk of burnout, anxiety and depressive disorders, and may then become less productive. This begs the question if a preventive intervention in the work setting might be cost-saving from a business perspective. Material and Methods: A cost-benefit analysis was conducted to evaluate the balance between the costs of a preventive intervention among nurses at elevated risk of mental health complaints and the cost offsets stemming from improved productivity. This evaluation was conducted alongside a cluster-randomized trial in a Dutch academic hospital. The control condition consisted of screening without feedback and unrestricted access to usual care (N = 206). In the experimental condition screen-positive nurses received personalized feedback and referral to the occupational physician (N = 207). Results: Subtracting intervention costs from the cost offsets due to reduced absenteeism and presenteeism resulted in net-savings of 244 euros per nurse when only absenteeism is regarded, and 651 euros when presenteeism is also taken into account. This corresponds to a return-on-investment of 5 euros up to 11 euros for every euro invested. Conclusions: Within half a year, the cost of offering the preventive intervention was more than recouped. Offering the preventive intervention represents a favorable business case as seen from the employer's perspective.

Productivity estimation in economic evaluations of occupational health and safety interventions: a systematic review

“…The remaining 4 studies (4%) all used ad hoc approaches that (41, 45-48, 51, 56-58, 60, 62, 64, 66, 68, 70, 72-75, 79, 81, 83, 84, 87-90, 92, 93, 95, 97, 98, 100-102, 105, 107-110, 113, 117-125) North-America 34 (39, 40, 43, 44, 50, 52-55, 59, 61, 63, 65, 69, 71, 76, 80, 82, 85, 86, 91, 94, 96, 99, 103, 106, 111, 112, 114-116, 126- (39, 41, 42, 44, 45,49,50,(52)(53)(54)(55)59,60,67,68,70,71,76,77,82,87,95,115, 128) Inferred: 19 (40, 43, 46,57,61,63,65,80,86,91,92,94,96,103,111,116,(125)(126)(127)56,62,64,66,69,72,73,75,78,79,81,(83)(84)(85)…”

“…Measure for reduced productivity at work/ while working 31 (39, 41-44, 56, 60-65, 69, 70, 72, 77, 82, 87, 89, 94, 95, 98, 103, 104, 114, 115, 118, 119, 123, 124, 128) Source presenteeism Employee survey 18 (41, 44,56,62,64,69,72,82,87,89,94,95,98,104,115,118,119, 123) Simulated / assumptions 7 (39, 43, 44,103,114,124, 128) Previous studies 6 (42,60,61,63,65,70) Firm data 1 (115) Employer survey 1 (77) Survey/instrument presenteeism 56,62,69,82,94,95,118,119,123) Days (unspecified) 49 (39, 40, 42, 46,49,(51)(52)(53)(54)58,60,62,64,66,71,72,74,75,(77)(78)…”

“…A generic national or regional price weight was used in 13 studies (19%), 9 (13%) used a worker-specific weight, 3 (4%) the industry or company average, and 1 (1%) a job average with age differentiation. Variations -such as using the mean annual salary per staff member in the NHSL (47), the study group average (75, 100), or the national average (41, 45,48,56,60,62,64,(66)(67)(68)(69)(70)72,(83)(84)(85)87,89,93,95,97,99,103,107,(118)(119)(120)(121)(122)(123)(124) 47,63,65,74,(77)(78)(79)81,82,87,(100)(101)(102)108,109,112,114,117,(126)(127)(128) (48, 52, 53, 58, 65-67, 69,...…”

“…No approach was stated in 4 studies (21%), while 3 (16%) used a direct approach, asking for "extra hours needed to catch up on tasks unable to complete in normal working hours" (41, 64) or the number of days with decreased efficiency at work (104). The perceived change approach was used in 2 studies (11%) that asked employees to give their productivity a 0-1 inefficiency score (87,89). (56), use both gross (total number of calendar days -partial or full -absent) and net (partial absent days) sick leave (70,100,103); and use short-term absences of 4-9 days (57), or absence spells >4 weeks (105).…”

“…Steel et al 39-42, 45-49, 51-54, 56-58, 60-75, 77-91, 93-128) Source absenteeism Firm data 26 (45, 46, 54, 57, 67-69, 71, 85, 86, 88, 91, 95, 96, 100, 101, 105, 107, 110, 114-116, 119, 125-127 (39, 42,49,51,56,57,62,64,66,72,78,79,81,82,87,89,94,102,104,109,113,117,118,(121)(122)(123)) Previous studies 10 (52, 53, 60, 61, 63, 83, 84, 99, 111, 120) Insurance data 9 (47, 48, 58, 60, 74, 75, 80, 112, 124 39, 42,49,56,72,79,81,82,102,104,109,117 11 (41, 56, 62, 93, 100, 107, 118, 119, 121-123) Estimated by the author 1 (88) The Chartered Institute of Personnel and Development 1 (108)…”