Abstract
BackgroundWorking women of childbearing age are a vital part of the population. Following childbirth, this group of women can experience a myriad of physical and mental health problems that can interfere with their ability to work. Currently, there is little known about cost-effective post-partum interventions to prevent work disability. The purpose of the study was to evaluate whether supervisor telephone contact (STC) during maternity leave is cost-effective from a societal perspective in reducing sick leave and improving quality-adjusted life years (QALYs) compared to common practice (CP).MethodsWe conducted an economic evaluation alongside a randomized controlled trial. QALYs were measured by the EuroQol 5-D, and sick leave and presenteeism by the Health and work Performance Questionnaire. Resource use was collected by questionnaires. Data were analysed according to intention-to-treat. Missing data were imputed via multiple imputation. Uncertainty was estimated by 95% confidence intervals, cost-utility planes and curves, and sensitivity analyses.Results541 working women from 15 companies participated. Response rates were above 85% at each measurement moment. At the end of the follow-up, no statistically significant between-group differences in QALYs, mean hours of sick leave or presenteeism or costs were observed. STC was found to be less effective and more costly. For willingness-to-pay levels from €0 through €50,000, the probability that STC was cost-effective compared to CP was 0.2. Overall resource use was low. Mean total costs were €3678 (95% CI: 3386; 3951). Productivity loss costs represented 37% of the total costs and of these costs, 48% was attributable to sick leave and 52% to work presenteeism. The cost analysis from a company's perspective indicated that there was a net cost associated with the STC intervention.ConclusionsSTC was not cost-effective compared to common practice for a healthy population of working mothers; therefore, implementation is not indicated. The cost-utility of STC for working mothers with more severe post-partum health problems, however, needs to be investigated. Work presenteeism accounted for half of the total productivity loss and warrants attention in future studies.Trial registration numberISRCTN: ISRCTN73119486
Highlights
Working women of childbearing age are a vital part of the population
Both groups had a similar number of women who had complete cost and quality-adjusted life years (QALYs) data: supervisor telephone contact (STC) = 200 (75%); common practice (CP) = 210 (76%)
Of the total productivity loss costs, 48% was attributable to sick leave and 52% to work presenteeism
Summary
Worldwide working women of childbearing age are a vital part of the population Following childbirth, this group of women can experience a myriad of physical and mental health problems that can interfere with their ability to work [1,2,3]. Cuelenaere et al [5] reported that the annual percentage of women with postpartum sick leave who qualified for work disability benefits was higher than the rest of the working population: 5% versus 1.5% These physical and mental health problems may interfere with a woman’s ability to work once she has returned to the workplace, that is, result in work presenteeism [6]. Given the similarity with the types of health problems faced by women following childbirth, the existence of work presenteeism is plausible
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