Improving a web-based employability intervention for work-disabled employees: results of a pilot economic evaluation

Figures & data

Table 1. Baseline characteristics (N = 63).

	Intervention group (n = 29)	Control group (n = 34)	p Values
Age, mean (SD)	51 (8)	53 (7.9)	0.4(a)
Female, N (%)	22 (76)	18 (53)	0.06(b)
Education^a, N (%)			0.8(b)
Low	2 (7)	3 (9)
Intermediate	10 (34)	14 (41)
High	17 (59)	17 (50)
Working hours, mean (sd)	26.5 (8.9)	29.3 (8.5)	0.2(a)
Living situation, N (%)			0.4(b)
Living alone	5 (17)	8 (24)
Living alone with children	–	2 (6)
Living together with a partner	14 (48)	17 (50)
Living together with partner and children	10 (35)	7 (20)
Job demands, N (%)			0.8(b)
Physical	2 (7)	1 (3)
Psychological	14 (48)	18 (53)
Both physical and psychological	13 (45)	15 (44)
Function, N (%)			0.14(b)
Industrial sector	–	2 (6)
Agricultural sector	1 (3)	–
Administrative sector	3 (10)	10 (29)
Service sector	1 (3)	–
Healthcare sector	15 (52)	9 (27)
Research & development	2 (7)	3 (9)
Other	7 (24)	10 (29)
Social benefits, N (%)			0.6(b)
WIA/WGA/WAJONG	3 (10)	3 (9)
Other	2 (7)	1 (3)
None	24 (83)	30 (88)
Permanent employment, N (%)	27 (93)	33 (97)	0.4(b)
Absenteeism days, mean (sd)	5.47 (8.6)	3.21 (6.9)	0.15(c)
Self-rated health^b, mean (sd)	67 (12.3)	75 (17.2)	0.015(c)
Costs, mean in €(sd)
Intervention	56.51 (22)	–	–
Medication	350.86 (926)	197.86 (679)	0.465(c)
Healthcare	644.91 (858)	918.50 (3052)	0.187(c)
Patient and family	68.39 (120)	48.53 (61.93)	0.341(c)
Absenteeism	847.05 (1439)	543.87 (1195)	0.243(c)
Presenteeism	241.87 (296)	311.81 (283)	0.189(c)

a Low, preschool or primary school; intermediate, lower- or upper secondary; high, tertiary school, university or postgraduate.

b Self-reported health score ranging 0 (worst) to 100 (best).

(a) ANOVA; (b) Х test; (c) Kruskal–Wallis test.

Figure 1. Cost-effectiveness planes for (A) cost-effectiveness analysis and (B) cost-utility analysis.

Table 2. Mean bootstrapped cost and effect differences between subgroups of the intervention- and control group including incremental cost-effectiveness ratios, 95% CIs and cost-effectiveness plane distributions.

	Sample size		ΔC	ΔE		Distribution of CE plane^c
Analysis	Intervention	Control	Euro	WAI QALY	ICER (95% CI)	%NE	%SE (dominant)	%SW	%NW (inferior)
Total group
CEA^a	29	34	483.8	−0.51	−948.37 (−1164; 335)	5	4	7	84
CUA^b	29	34	483.8	−0.01	−45 045.13 (−51 078; 11 526)	6	3	9	82
CEA Subgroup
Aged under 50	12	12	345.94	−0.67	−518.91 (−496; −3133)	3	7	16	75
Aged above 50	17	22	9.74	0.03	280 (−88; 2318)	13	41	8	38
Females	22	18	58.01	0.05	1276.16 (5450; 10 667)	19	35	10	36
Males	7	16	1147.36	−1.37	−839.90 (−970; 151)	4	4	2	91
Working hours >20	21	28	261.54	−0.57	−457.69 (1354; 4588)	1	7	22	70

a In the CEA ΔE is the mean difference in work ability (WAI score), ΔC is the mean difference in societal costs.

b In the CUA ΔE is the mean difference in QALYs, ΔC is the mean difference in societal costs.

c NE refers to north-east quadrant of the cost-effectiveness plane, which indicates the intervention is more effective and more costly than the control. SE refers to the south-east quadrant of the cost-effectiveness plane, which indicates the intervention is more effective and less costly than the control. SW refers to south-west quadrant of the cost-effectiveness plane, which indicates the intervention is less effective and less costly than the control. NW refers to north-west quadrant of the cost-effectiveness plane, which indicates the intervention is less effective and more costly than the control.

Table 3. Cost prices, mean total costs (SD) and mean bootstrapped costs (95% CI) during the 3-month follow-up (n = 63).

		Mean costs (SD)		Mean bootstrapped costs (95% CI^a)
Cost type	Cost price per unit (€)^b	Intervention group	Control group	Intervention group	Control group
Healthcare costs		399.7 (386.1)	365.9 (566.99)	399 (270;543)	366 (194;574)
General practitioner	30.5	37.1 (63.3)	40.59 (66)	36 (17;62)	40 (22;65)
Physiotherapist	33.7	165.1 (225.7)	102.1 (180.72)	165 (91;250)	102 (49;165)
Occupational physician	38.1	16.5 (40)	26.39 (48.23)	17 (5;33)	26 (12;43)
Medical specialist	34.3	27 (40.32)	25 (47.21)	27 (14;43)	25 (11;42)
Psychologist	94.3	31.5 (80.2)	91 (216.04)	30 (4;64)	90 (27;169)
Hospital admission	549.7	19.3 (102.03)	0.27 (1.55)	19 (0;57)	0
Hospital care day parts	273.2	19.3(101.41)	8.43 (46.84)	19 (0; 57)	8 (0; 25)
Alternative care	67.1	75.6 (170)	21.1 (60.78)	75 (24; 144)	21 (4; 44)
Home care	71.6	8.5 (40.11)	54.47 (248.85)	9 (0; 24)	51 (0; 143)
Medication costs	Variable^c	280.3 (846.36)	147.9 (299.62)	281 (84; 627)	148 (69; 262)
Patient and family costs	Variable^d	43.5 (45.4)	46.9 (64.28)	43 (29; 61)	47 (28; 69)
Costs in other sectors		890.1 (1334.35)	662.2 (1028.5)	890 (457; 1411)	661 (364; 1040)
Absenteeism	Age & gender specific wages^e	724.4 (1330.65)	464.5 (1064.96)	723 (293; 1250)	462 (150; 853)
Presenteeism	Age & gender specific wages^e	165.7 (71.98)	197.7 (89.22)	166 (141; 192)	198 (168; 226)
Total social costs		1706.8 (1675.1)^f	1223 (1539.97)	1707 (1153; 2327)	1223 (758; 1767)

a The upper and lower confidence limits are the 2.5th and 97.5th percentile based on 10 000 bootstrap replications.

b Standard costs for the Netherlands, 2013 index.

c Dutch Pharmacotherapeutic Compass.

d Including informal care costs and travel and parking costs.

e Dutch guidelines for costing studies.

f Deviation from the sum due to the inclusion of per-participant intervention costs.

Appendix Table 1. Costs (all in EURO) of the web-based employability intervention.

Intervention component	Units	Unit prices	Annual costs (n = 336)	Participant costs
(i) Operational costs website “Wijzer met Welder”
Maintenance ICT	52	45	2340	6.96
Actualization content	52	65	3380	10.06
Content support	260	45	11 700	34.82
Hosting, telephone, etc.	^a	NA	3500	10.42
Handling – administration	52	35	1820	5.42
Customer management	16	80	1280	3.81
Marge	^a	NA	1500	4.46
Total costs per participant per year			25 520	75.95
Total costs per participant – 3-month follow-up				18.99
(ii) Utilization costs WAI-test
Price arrangement (invoice) – license: WAI-test including questionnaires,  updates and protocol	NA	NA	1337	3.98
Total costs per participant per year				3.98
Total costs per participant – 3-month follow-up				1.00
(iii) Feedback coach
Facilitating	10 min	47.7	NA	7.95
Preparation	10 min	47.7	NA	7.95
Conversation	30 min	47.7	NA	23.85
Registration	1 min	47.7	NA	0.795
Total costs per participant per uptake				40.55
(iv)Personal advice
Mailing or advisory telephone line	15 min	47.7	NA	11.925
Registration	5 min	47.7	NA	3.975
Total costs per participant per uptake				15.9
(v)Forum
Moderator	5 h per week	95	24,700	73.51
Total costs per participant per uptake				73.51

NA, not applicable.

a Average estimate.