{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T07:11:46Z","timestamp":1768547506582,"version":"3.49.0"},"reference-count":45,"publisher":"BMJ","issue":"10","funder":[{"DOI":"10.13039\/501100007344","name":"Achmea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007344","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,9,15]]},"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the health-economic costs and benefits of a guided eHealth intervention (E-health module embedded in Collaborative Occupational healthcare (ECO)) encouraging sick-listed employees to a faster return to work.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A two-armed cluster randomised trial with occupational physicians (OPs) (n=62), clustered and randomised by region into an experimental and a control group, to conduct a health-economic investment appraisal. Online self-reported data were collected from employees at baseline, after 3, 6, 9 and 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Occupational health care in the Netherlands.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Employees from small-sized and medium-sized companies (\u226518 years), sick-listed between 4 and 26 weeks with (symptoms of) common mental disorders visiting their OP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>In the intervention group, employees (N=131) received an eHealth module aimed at changing cognitions regarding return to work, while OPs were supported by a decision aid for treatment and referral options. Employees in the control condition (N=89) received usual sickness guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes Measures<\/jats:title>\n                    <jats:p>Net benefits and return on investment based on absenteeism, presenteeism, health care use and quality-adjusted life years (QALYs) gained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From the employer\u2019s perspective, the incremental net benefits were \u20ac3187 per employee over a single year, representing a return of investment of \u20ac11 per invested Euro, with a break-even point at 6 months. The economic case was also favourable from the employee\u2019s perspective, partly because of QALY health gains. The intervention was costing \u20ac234 per employee from a health service financier\u2019s perspective. The incremental net benefits from a social perspective were \u20ac4210. This amount dropped to \u20ac3559 in the sensitivity analysis trimming the 5% highest costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The data suggest that the ECO intervention offers good value for money for virtually all stakeholders involved, because initial investments were more than recouped within a single year. The sometimes wide 95% CIs suggest that the costs and benefits are not always very precise estimates and real benefits could vary considerably.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>NTR2108; Results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-016348","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T16:39:17Z","timestamp":1715877557000},"page":"e016348","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Return-to-work intervention versus usual care for sick-listed employees: health-economic investment appraisal alongside a cluster randomised trial"],"prefix":"10.1136","volume":"7","author":[{"given":"Suzanne","family":"Lokman","sequence":"first","affiliation":[{"name":"Public Mental Health, Trimbos Institute, Utrecht, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Volker","sequence":"additional","affiliation":[{"name":"Innovation of Care, Trimbos Institute, Utrecht, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moniek C","family":"Zijlstra-Vlasveld","sequence":"additional","affiliation":[{"name":"Public Mental Health, Trimbos Institute, Utrecht, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evelien PM","family":"Brouwers","sequence":"additional","affiliation":[{"name":"Tranzo, Tilburg University Tilburg School of Social and Behavioral Sciences, Tilburg, Noord-Brabant, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brigitte","family":"Boon","sequence":"additional","affiliation":[{"name":"Center of Innovation, Trimbos Institute, Utrecht, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aartjan TF","family":"Beekman","sequence":"additional","affiliation":[{"name":"EMGO Institute for Health and Care Research, Amsterdam, Netherlands"},{"name":"Department of Psychiatry, VU University Medical Center Amsterdam, Amsterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filip","family":"Smit","sequence":"additional","affiliation":[{"name":"Public Mental Health, Trimbos Institute, Utrecht, Netherlands"},{"name":"EMGO Institute for Health and Care Research, Amsterdam, Netherlands"},{"name":"Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina M","family":"Van der Feltz-Cornelis","sequence":"additional","affiliation":[{"name":"Tranzo, Tilburg University Tilburg School of Social and Behavioral Sciences, Tilburg, Noord-Brabant, Netherlands"},{"name":"Clinical Centre of Excellence for Body, Mind and Health, GGZ Breburg, Tilburg, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,10,5]]},"reference":[{"key":"2025121508222523000_7.10.e016348.1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200305000-00012"},{"key":"2025121508222523000_7.10.e016348.2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.163.9.1569"},{"key":"2025121508222523000_7.10.e016348.3","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/22.1.59"},{"key":"2025121508222523000_7.10.e016348.4","first-page":"86","article-title":"Patient factors associated with duration of certified sickness absence and transition to long-term incapacity","volume":"54","author":"Shiels","year":"2004","journal-title":"Br J Gen Pract"},{"key":"2025121508222523000_7.10.e016348.5","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/kqr008"},{"key":"2025121508222523000_7.10.e016348.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61689-4"},{"key":"2025121508222523000_7.10.e016348.7","unstructured":"de Graaf R , Tuithof M , van Dorsselaer S , et al . 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