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Economic Evaluation of an Occupational Health Care Guideline for Prevention of Weight Gain Among Employees

van Wier, Marieke F. PhD; Verweij, Lisanne M. PhD; Proper, Karin I. PhD; Hulshof, Carel T.J. PhD; van Tulder, Maurits W. PhD; van Mechelen, Willem PhD

Journal of Occupational & Environmental Medicine: September 2013 - Volume 55 - Issue 9 - p 1100–1109
doi: 10.1097/JOM.0b013e31829b279a
Original Articles

Objective: To determine the cost-effectiveness and the financial return of a guideline for occupational physicians (OPs), aimed at the prevention of weight gain among employees.

Methods: The guideline consisted of a company-environment scan and up to five individual sessions with an OP. Sixteen OPs randomized to the guideline (n = 7) or usual care group (n = 9) recruited 275 and 249 employees. Costs were collected by using 3-monthly retrospective questionnaires. Quality-adjusted life-years gained were determined with 6-monthly administered EuroQol-5D. Waist circumference and body weight were measured at baseline and 18 months.

Results: Unfavorable differences were found on waist circumference (+1.6 cm; 95% confidence interval [CI], 0.27 to 2.90) and weight (+1.1 kg; 95% CI, 0.01 to 2.15). Probabilities of cost-effectiveness were consistently less than 55%. Net employer loss was €−158 (95% CI, −2865 to 2672).

Conclusions: The occupational health care guideline was not cost-effective and no financial return was shown.

From the Departments of Epidemiology and Biostatistics (Dr van Wier and Dr van Tulder) and Public and Occupational Health (Drs Verweij, Proper, and van Mechelen), EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands; Body@Work (Dr van Wier and Drs Verweij, Proper, van Tulder, and van Mechelen), Research Center on Physical Activity, Work and Health, TNO–VU University Medical Center, Amsterdam, the Netherlands; Netherlands Society of Occupational Medicine (Dr Hulshof), Centre of Excellence, Utrecht, the Netherlands; Academic Medical Center (Dr Hulshof), Coronel Institute of Occupational Health, Amsterdam, the Netherlands; and Department of Health Sciences (Dr van Tulder), Faculty of Earth and Life Sciences, Institute of Health Sciences, VU University, Amsterdam, the Netherlands.

Address correspondence to: Marieke F. van Wier, PhD, Faculty of Earth and Life Sciences, Institute of Health Sciences, VU University, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands (mvanwier@gmail.com).

This research was supported by The Netherlands Organization for Health Research and Development (ZonMw), project 120510007.

All authors declare no competing interests.

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Copyright © 2013 by the American College of Occupational and Environmental Medicine