Protecting and promoting mental health of nurses in the hospital setting: Is it cost-effective from an employer’s perspective?
Filip Smit 1,4,5
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Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, the Netherlands (Department of Public Mental Health)
Maastricht University, Maastricht, the Netherlands (Department of Health Services Research, CAPHRI School of Public Health and Primary Care)
Academic Medical Center, Amsterdam, the Netherlands (Coronel Institute of Occupational Health)
VU University Medical Centre, Amsterdam, the Netherlands (Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research)
VU University Medical Centre, Amsterdam, the Netherlands (Department of Clinical Psychology, EMGO+ Institute for Health and Care Research)
Corresponding author
Cindy Noben   

Maastricht University, Department of Health Services Research, P.O. Box 616, 6200 MD Maastricht, the Netherlands
Int J Occup Med Environ Health. 2015;28(5):891-900
Objectives: Nurses are at elevated risk of burnout, anxiety and depressive disorders, and may then become less productive. This begs the question if a preventive intervention in the work setting might be cost-saving from a business perspective. Material and Methods: A cost-benefit analysis was conducted to evaluate the balance between the costs of a preventive intervention among nurses at elevated risk of mental health complaints and the cost offsets stemming from improved productivity. This evaluation was conducted alongside a cluster-randomized trial in a Dutch academic hospital. The control condition consisted of screening without feedback and unrestricted access to usual care (N = 206). In the experimental condition screen-positive nurses received personalized feedback and referral to the occupational physician (N = 207). Results: Subtracting intervention costs from the cost offsets due to reduced absenteeism and presenteeism resulted in net-savings of 244 euros per nurse when only absenteeism is regarded, and 651 euros when presenteeism is also taken into account. This corresponds to a return-on-investment of 5 euros up to 11 euros for every euro invested. Conclusions: Within half a year, the cost of offering the preventive intervention was more than recouped. Offering the preventive intervention represents a favorable business case as seen from the employer’s perspective.
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