Economic Evaluations of Occupational Health Interventions from a Corporate Perspective-A Systematic Review of Methodological Quality

• Published in: Scandinavian Journal of Work, Environment ＆ Health Vol. 36; no. 4; pp. 273 - 288
• Main Authors: Uegaki, Kimi, de Bruijne, Martine C, Lambeek, Ludeke, Anema, Johannes R, van der Beek, Allard J, van Mechelen, Willem, van Tulder, Maurits W
• Format: Journal Article
• Language: English
• Published: Finland Scandinavian Journal of Work, Environment ＆ Health 01-07-2010; Finnish Institute of Occupational Health; National Institute of Occupational Health; National Research Centre for the Working Environment; Scandinavian Journal of Work, Environment & Health; Nordic Association of Occupational Safety and Health (NOROSH)
• Subjects: corporate perspective; Cost estimates; Cost savings; Costs and Cost Analysis; Economic costs; economic evaluation; Economic research; economics; Health care costs; health intervention; Health promotion; methodological quality; methodology; National Institute for Occupational Safety and Health (U.S.); Occupational Health; occupational health intervention; Occupational safety; occupational safety and health; osh; osh intervention; Physical trauma; Psychoeducational intervention; Review; Savings; Sensitivity analysis; Sick leave; State Medicine; Systematic review; United Kingdom; United States; Value appraisal; work; Canada, Alberta, Cochrane; economics; OSH; OSH interventions; occupational safety and health; review; work
• ISSN: 0355-3140; 1795-990X
• DOI: 10.5271/sjweh.3017

Objective Using a standardized quality criteria list, we appraised the methodological quality of economic evaluations of occupational safety and health (OSH) interventions conducted from a corporate perspective. Methods The primary literature search was conducted in Mediine and Embase. Supplemental searches were conducted in the Cochrane NHS Economic Evaluation Database, the National Institute for Occupational Safety and Health (NIOSH) database, the Ryerson International Labour, Occupational Safety and Health Index, scans of reference lists, and researchers' own literature database. Independently, two researchers selected articles based on title, keywords, and abstract, and if needed, fulltext. Disagreements were resolved by a consensus procedure. Articles were selected based on seven criteria addressing study population, type of intervention, comparative intervention, outcome, costs, language, and perspective. Two reviewers independently judged methodological quality using the Consensus on Health Economic Criteria (CHEC-list), a 19-item standardized quality criteria list. Disagreements in judgment were also resolved by consensus. Data were analyzed descriptively. Results A total of 34 studies were included. Of these, only 44% of the studies met more than 50% of the quality criteria. Of the 19 quality criteria, 8 were met by 50% or more of the studies. The 11 least-fulfilled criteria related to: (i) performance of a sensitivity analysis, (ii) selection of perspective, (iii) description of study population, (iv) discussion of generalizability, (v) description of competing alternatives, (vi) presentation of the research question, (vii) measurement of outcomes, (viii) measurement of costs, (ix) valuation of costs, (x) declaration of researchers' independence, and (xi) discussion of ethical and distributional issues. Conclusions Apart from a few exceptions, the overall methodological quality of the economic evaluations of OSH interventions from a corporate perspective was poor. As such, there is a risk of biased results. The quality of future evaluations needs to be improved to increase the validity of their conclusions and recommendations.