Implementing interventions to reduce work-related stress among health-care workers: an investment appraisal from the employer\u2019s perspective

Ben F M Wijnen,Bo M Havermans,Allard J Van Der Beek,Filip Smit,Cecile Boot,Joran Lokkerbol

doi:10.1007/s00420-019-01471-y

Abstract

PurposeThe Stress-Prevention@Work implementation strategy has been demonstrated to be successful in reducing stress in employees. Now, we assess the economic return-on-investment to see if it would make for a favourable business case for employers.MethodsData were collected from 303 health-care workers assigned to either a waitlisted control condition (142 employees in 15 teams) or to Stress-Prevention@Work (161 employees in 15 teams). Main outcome was productivity losses measured using the Trimbos and iMTA Cost questionnaire in Psychiatry. Measurements were taken at baseline, 6, and 12 months post-baseline.ResultsThe per-employee costs of the strategy were €50. Net monetary benefits were the benefits (i.e., improved productivity) minus the costs (i.e., intervention costs) and were the main outcome of this investment appraisal. Per-employee net benefits amounted to €2981 on average, which was an almost 60-fold payout of the initial investment of €50. There was a 96.7% likelihood for the modest investment of €50 to be offset by cost savings within 1 year. Moreover, a net benefit of at least €1000 still has a likelihood of 88.2%.ConclusionsIn general, there was a high likelihood that Stress-Prevention@Work offers an appealing business case from the perspective of employers, but the employer should factor in the additional per-employee costs of the stress-reducing interventions. Still, if these additional costs were as high as €2981, then costs and benefits would break even.This study was registered in the Netherlands National Trial Register, trial code: NTR5527.

Highlights

Work-related stress is common in the health workforce (Ruotsalainen et al 2008, 2015; Dharmawardene et al 2016) and may compromise both health of the staff working at health services (Ganster and Rosen 2013; Steptoe and Kivimäki 2013) and the quality of the work for the patients they serve
As the paper compromised an investment appraisal, we looked at both costs and benefits, which are described below
We had no information about the team membership of one individual in the control condition and that information was required for conducting the design-based regression analysis to account for clustering of employees in teams

Summary

Introduction

Work-related stress is common in the health workforce (Ruotsalainen et al 2008, 2015; Dharmawardene et al 2016) and may compromise both health of the staff working at health services (Ganster and Rosen 2013; Steptoe and Kivimäki 2013) and the quality of the work for the patients they serve. Higher levels of stress are likely to translate into absenteeism from work (Henderson et al 2005; Ruotsalainen et al 2015) and reduced productivity while at work (Ganster and Rosen 2013; Steptoe and Kivimäki 2013). Over the 10–20 years, stress in the workforce for health is likely to increase, because health services will be increasingly stretched by an intensified demand for health care by Europe’s greying populations, yet the workforce in the health-care sector is ageing at the same rate (Dussault et al 2010). Compared to other occupations, levels of dissatisfaction, distress and burnout at work are already relatively high in health care (McNeely 2005; Ruotsalainen et al 2008, 2015)

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