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A health economic outcome evaluation of an internet-based mobile-supported stress management intervention for employees
Author(s) -
David Daniel Ebert,
Fanny Kählke,
Claudia Buntrock,
Matthias Berking,
Filip Smit,
Elena Heber,
Harald Baumeister,
Burkhardt Funk,
Heleen Riper,
Dirk Lehr
Publication year - 2017
Publication title -
scandinavian journal of work, environment and health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.621
H-Index - 103
eISSN - 1795-990X
pISSN - 0355-3140
DOI - 10.5271/sjweh.3691
Subject(s) - medicine , randomized controlled trial , physical therapy , stress management , randomization , psychological intervention , confidence interval , cost effectiveness , intervention (counseling) , clinical psychology , nursing , surgery , risk analysis (engineering)
Objective This study aimed to estimate and evaluate the cost-effectiveness and cost-benefit of a guided internet- and mobile-supported occupational stress-management intervention (iSMI) for employees from the employer's perspective alongside a randomized controlled trial. Methods A sample of 264 employees with elevated symptoms of perceived stress (Perceived Stress Scale, PSS-10 ≥22) was randomly assigned either to the iSMI or a waitlist control (WLC) group with unrestricted access to treatment as usual. The iSMI consisted of seven sessions of problem-solving and emotion-regulation techniques and one booster session. Self-report data on symptoms of perceived stress and economic data were assessed at baseline, and at six months following randomization. A cost-benefit analysis (CBA) and a cost-effectiveness analysis (CEA) with symptom-free status as the main outcome from the employer's perspective was carried out. Statistical uncertainty was estimated using bootstrapping (N=5000). Results The CBA yielded a net-benefit of EUR181 [95% confidence interval (CI) -6043-1042] per participant within the first six months following randomization. CEA showed that at a willingness-to-pay ceiling of EUR0, EUR1000, EUR2000 for one additional symptom free employee yielded a 67%, 90%, and 98% probability, respectively, of the intervention being cost-effective compared to the WLC. Conclusion The iSMI was cost-effective when compared to WLC and even lead to cost savings within the first six months after randomization. Offering stress-management interventions can present good value for money in occupational healthcare.