An economic evaluation of a worksite intervention to promote work ability and health-related quality of life in the construction industry

Introduction
The working population is ageing and a shortage of workers is expected in the construction industry. A worksite prevention program was therefore conducted to promote the work ability of construction workers and thereby prolong a healthy working life. The aim of the study was to evaluate the cost-effectiveness of this workplace intervention.

Methods
The economic evaluation was conducted alongside a randomized controlled trial (RCT). Participating construction workers from 6 companies (n=293) were assigned to either the intervention group (n=172) or the usual care group (n=123) by means of cluster randomization. The worksite prevention program lasted six months and consisted of two individual visits of a physical therapist, an instrument to raise awareness of the importance of rest breaks to reduce fatigue, and two empowerment training sessions. The outcomes were work ability and quality of life. Cost data included intervention costs (i.e., materials, training costs) and absenteeism costs. Cost-effectiveness analyses were performed from the employer perspective. Missing data were imputed using multiple imputations. Cost-effectiveness analyses were performed by means of bootstrapping.

Results
With regard to work ability and health-related quality of life, no significant effects were found. The mean intervention costs were €118 per participant. After 12 months, the absenteeism costs were €1891 per participant in the intervention group compared to €2748 per participant in the control group. From the company perspective, the cost-effectiveness showed that the prevention program was not cost-effective in comparison to the control group

Discussion
Overall, after 12 months, the prevention program at the worksite did not prove to be cost-effective when work ability and health-related quality of life were used as outcome measures. The findings of the present study do not provide a financial reason for implementing this intervention. Future analyses should confirm if the program is cost-effective for a subgroup of construction workers.