Affecting patients with work-related problems by educational training of their GPs: a cost-effectiveness study

被引:1
作者
de Kock, Cornelis [1 ]
Noben, Cindy [2 ,9 ]
Lagro-Janssen, Antoine [2 ]
Lucassen, Peter [3 ]
Knottnerus, Andre [4 ]
de Rijk, Angelique [5 ]
Nijhuis, Frans [6 ]
Steenbeek, Romy [7 ]
Evers, Silvia [2 ,8 ]
机构
[1] Radboud Univ Nijmegen, Dept Primary & Community Care, Med Ctr, Gender & Womens Hlth, POB 9101, NL-6500 HB Nijmegen, Netherlands
[2] Maastricht Univ, CAPHRI Sch Publ Hlth & Primary Care, Dept Hlth Serv Res, Maastricht, Netherlands
[3] Radboud Univ Nijmegen, Dept Primary & Community Care, Med Ctr, Nijmegen, Netherlands
[4] Maastricht Univ, Dept Gen Practice, Maastricht, Netherlands
[5] Maastricht Univ, CAPHRI Sch Publ Hlth & Primary Care, Dept Social Med, Maastricht, Netherlands
[6] Maastricht Univ, Dept Work & Social Psychol, Maastricht, Netherlands
[7] TNO Work Hlth & Care, Leiden, Netherlands
[8] Trimbos Inst, Netherlands Inst Mental Hlth & Addict, Utrecht, Netherlands
[9] Maastricht Univ, OOR ZON, Med Ctr, Maastricht, Netherlands
关键词
Health economics; Occupational; environmental medicine; Primary care; Randomized controlled trial; Rehabilitation; disabilities; GENERAL-PRACTITIONERS; OCCUPATIONAL PHYSICIANS; SICKNESS CERTIFICATION; EMPLOYEES; HEALTH; RETURN; MANAGEMENT; DURATION; IMPROVE; ABSENCE;
D O I
10.1186/s12875-019-0924-9
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
BackgroundAssessing the cost effectiveness of training aimed at increasing general practitioners' (GP) work awareness and patients' work-related self-efficacy and quality of life.MethodsA cluster randomized controlled trial in twenty-six GP practices in the southeast of the Netherlands with 32 participating GPs. GPs working in an intervention group practice received training and GPs working in a control group practice delivered usual care. The training intervention consisted of lectures and workshops aimed at increasing GPs' work awareness and more proactive counseling for patients with work-related problems (WRP). Subjects were working age patients with paid work for at least 12h per week, who visited one of the participating GPs during the study period. As outcome measures we used the Return to Work Self Efficacy scale to assess patients' work-related self-efficacy and the Euroquol to assess quality of life. We also measured health care costs and productivity costs. With a 4-item questionnaire we asked patients to assess their GPs' work awareness. Data were collected at baseline, after 6 and 12months.ResultsData of 280 patients could be analyzed. The patient related outcomes did not improve after GP training. The change in GP work awareness and the overall mean cost difference (of Euro770) in favor of the intervention group were not significant.ConclusionsThe training intervention presented in this paper was not cost-effective. Training which is further personalized and targeted at high risk groups with respect to WRP, is more likely to be cost effective.
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页数:10
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