Abstract
Background: The study evaluates the cost-effectiveness of the Productivity Measurement and Enhancement System (ProMes) intervention to reduce employee work-related stress and enhance work performance. Methods: A prospective cohort study was used to undertake the evaluation from a business perspective. Objective workload data and stress were gathered repeatedly over a 17-month period (i.e., before and after intervention). Independent t-test and an interrupted time series (ITS) analysis were used in the analysis. The average cost-effectiveness ratio (ACER) was calculated as a ratio of the average cost of the intervention and the effect sizes of the different outcomes to reflect the average cost per clinician for each unit change in outcome. Results: Based on the results of the ITS analysis, an expenditure of EUR 41,487 was linked with no change in stress levels, according to the ACER for stress. In addition, the expenditures associated with each unit change were EUR 3319 for overall tasks per hour worked, EUR 2761 for visits per hour worked, EUR 2880 for administrative tasks, but EUR 9123 for answering phone calls. Conclusions: ProMes is not cost–effective in terms of work-related stress levels, but the intervention seemed to have increased efficiency in some objective work performance measures, albeit at a relatively high extra cost.
Highlights
Thomas TenkateWork-related stress is prevalent and a major challenging issue facing occupational safety and health internationally [1,2,3]
The ratios for visits and administration were higher at post- than pre-intervention, indicating that there was a decrease in efficiency with more hours worked per visit completed/administrative tasks done
According to the independent t-test, our findings indicated that Productivity Measurement and Enhancement System (ProMes) is not a cost–effective intervention since stress levels increased and efficiency decreased during the intervention, at extra cost to the primary healthcare unit
Summary
Thomas TenkateWork-related stress is prevalent and a major challenging issue facing occupational safety and health internationally [1,2,3]. Sweden, it is the most frequent cause of sickness absence [4]. Stress-related diagnoses, together with mood and anxiety diagnoses, are associated with longer sick leave than most other illnesses in Sweden [2,5]. The study evaluates the cost-effectiveness of the Productivity Measurement and Enhancement System (ProMes) intervention to reduce employee work-related stress and enhance work performance. The expenditures associated with each unit change were EUR 3319 for overall tasks per hour worked, EUR 2761 for visits per hour worked, EUR 2880 for administrative tasks, but EUR 9123 for answering phone calls. Conclusions: ProMes is not cost–effective in terms of work-related stress levels, but the intervention seemed to have increased efficiency in some objective work performance measures, albeit at a relatively high extra cost
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