Effectiveness, cost-effectiveness and return on investment of individual placement and support compared with traditional vocational rehabilitation for individuals with severe mental illness in the Netherlands: a nationwide implementation study
Objectives To assess the effectiveness, cost-effectiveness and return on investment of individual placement and support (IPS) implemented through a reimbursement strategy on a nationwide scale compared with traditional vocational rehabilitation (TVR) regarding sustainable participation in competitiv...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2024-04-01
|
| Series: | BMJ Public Health |
| Online Access: | https://bmjpublichealth.bmj.com/content/2/1/e000393.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832583196694282240 |
|---|---|
| author | Johanna Maria van Dongen Philippe Delespaul Frederieke Schaafsma Jaap van Weeghel Johannes Anema Miljana Vukadin Wim Zwinkels Marcel Spijkerman Marloes de Graaf-Zijl |
| author_facet | Johanna Maria van Dongen Philippe Delespaul Frederieke Schaafsma Jaap van Weeghel Johannes Anema Miljana Vukadin Wim Zwinkels Marcel Spijkerman Marloes de Graaf-Zijl |
| author_sort | Johanna Maria van Dongen |
| collection | DOAJ |
| description | Objectives To assess the effectiveness, cost-effectiveness and return on investment of individual placement and support (IPS) implemented through a reimbursement strategy on a nationwide scale compared with traditional vocational rehabilitation (TVR) regarding sustainable participation in competitive employment in individuals with severe mental illness receiving sickness or disability benefits.Methods An observational study was conducted using administrative data regarding all Dutch individuals receiving sickness or disability benefits in the period 2012–2019. Exact matching and difference-in-difference fixed-effect estimations were performed to handle the non-randomised nature of the data. The matched sample consisted of 863 IPS and 16 466 TVR participants. The primary effect measure was the proportion of individuals having worked for at least 48 hours per month in competitive employment (ie, for 12 hours or more per week); the proportion of individuals having worked in competitive employment for at least 1 hour per month was also evaluated. Cost-effectiveness and return on investment were assessed from the societal perspective (intervention, sickness/disability benefit and healthcare costs) and payer perspective (sickness/disability benefit costs).Results IPS led to a statistically significant higher probability of being competitively employed for at least 12 hours per week of 3.7% points (95% CI 0.8% to 6.7%) to 7.5% points (95% CI 3.8% to 11.3%) and of being competitively employed for at least 1 hour per month of 4.7% points (95% CI 1.6% to 7.7%) to 8.9% points (95% CI 5.2 to 12.6%) from 6 to 36 months after starting the intervention. From the societal and payer perspective, IPS was—on average—less costly and more effective than TVR and return-on-investment estimates showed that IPS was—on average—cost saving (eg, societal perspective: ∆C: −364 (95% CI −3977 to 3249); ∆E: 0.104 (95% CI 0.046 to 0.164); benefit–cost ratio: 2.1 (95% CI −14.8 to 19.1)), but the uncertainty surrounding these estimates was large.Conclusions IPS implemented through a reimbursement strategy on a nationwide scale is more effective and potentially cost-effective than TVR in people with severe mental illness receiving sickness or disability benefits. Based on these results, the implementation of IPS by a wide scale reimbursement strategy could be promoted to enhance sustainable participation in competitive employment in these individuals. Future economic evaluations should strive for a more robust sample size and a long follow-up period. |
| format | Article |
| id | doaj-art-ded7550962ae438d8bd3e3d42e7648f0 |
| institution | Kabale University |
| issn | 2753-4294 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Public Health |
| spelling | doaj-art-ded7550962ae438d8bd3e3d42e7648f02025-01-29T02:55:09ZengBMJ Publishing GroupBMJ Public Health2753-42942024-04-012110.1136/bmjph-2023-000393Effectiveness, cost-effectiveness and return on investment of individual placement and support compared with traditional vocational rehabilitation for individuals with severe mental illness in the Netherlands: a nationwide implementation studyJohanna Maria van Dongen0Philippe Delespaul1Frederieke Schaafsma2Jaap van Weeghel3Johannes Anema4Miljana Vukadin5Wim Zwinkels6Marcel Spijkerman7Marloes de Graaf-Zijl8Department of Health Sciences, Amsterdam Public Health Research Institute, Amsterdam, The NetherlandsDepartment of Psychiatry and Neuropsychology, Universiteit Maastricht School for Mental Health and Neuroscience, Maastricht, The NetherlandsAmsterdam UMC Locatie AMC, Amsterdam, Netherlands1 Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The NetherlandsDepartment of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The NetherlandsDepartment of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The NetherlandsEpsilon Research, Leiden, The NetherlandsUWV, Amsterdam, The NetherlandsUWV, Amsterdam, The NetherlandsObjectives To assess the effectiveness, cost-effectiveness and return on investment of individual placement and support (IPS) implemented through a reimbursement strategy on a nationwide scale compared with traditional vocational rehabilitation (TVR) regarding sustainable participation in competitive employment in individuals with severe mental illness receiving sickness or disability benefits.Methods An observational study was conducted using administrative data regarding all Dutch individuals receiving sickness or disability benefits in the period 2012–2019. Exact matching and difference-in-difference fixed-effect estimations were performed to handle the non-randomised nature of the data. The matched sample consisted of 863 IPS and 16 466 TVR participants. The primary effect measure was the proportion of individuals having worked for at least 48 hours per month in competitive employment (ie, for 12 hours or more per week); the proportion of individuals having worked in competitive employment for at least 1 hour per month was also evaluated. Cost-effectiveness and return on investment were assessed from the societal perspective (intervention, sickness/disability benefit and healthcare costs) and payer perspective (sickness/disability benefit costs).Results IPS led to a statistically significant higher probability of being competitively employed for at least 12 hours per week of 3.7% points (95% CI 0.8% to 6.7%) to 7.5% points (95% CI 3.8% to 11.3%) and of being competitively employed for at least 1 hour per month of 4.7% points (95% CI 1.6% to 7.7%) to 8.9% points (95% CI 5.2 to 12.6%) from 6 to 36 months after starting the intervention. From the societal and payer perspective, IPS was—on average—less costly and more effective than TVR and return-on-investment estimates showed that IPS was—on average—cost saving (eg, societal perspective: ∆C: −364 (95% CI −3977 to 3249); ∆E: 0.104 (95% CI 0.046 to 0.164); benefit–cost ratio: 2.1 (95% CI −14.8 to 19.1)), but the uncertainty surrounding these estimates was large.Conclusions IPS implemented through a reimbursement strategy on a nationwide scale is more effective and potentially cost-effective than TVR in people with severe mental illness receiving sickness or disability benefits. Based on these results, the implementation of IPS by a wide scale reimbursement strategy could be promoted to enhance sustainable participation in competitive employment in these individuals. Future economic evaluations should strive for a more robust sample size and a long follow-up period.https://bmjpublichealth.bmj.com/content/2/1/e000393.full |
| spellingShingle | Johanna Maria van Dongen Philippe Delespaul Frederieke Schaafsma Jaap van Weeghel Johannes Anema Miljana Vukadin Wim Zwinkels Marcel Spijkerman Marloes de Graaf-Zijl Effectiveness, cost-effectiveness and return on investment of individual placement and support compared with traditional vocational rehabilitation for individuals with severe mental illness in the Netherlands: a nationwide implementation study BMJ Public Health |
| title | Effectiveness, cost-effectiveness and return on investment of individual placement and support compared with traditional vocational rehabilitation for individuals with severe mental illness in the Netherlands: a nationwide implementation study |
| title_full | Effectiveness, cost-effectiveness and return on investment of individual placement and support compared with traditional vocational rehabilitation for individuals with severe mental illness in the Netherlands: a nationwide implementation study |
| title_fullStr | Effectiveness, cost-effectiveness and return on investment of individual placement and support compared with traditional vocational rehabilitation for individuals with severe mental illness in the Netherlands: a nationwide implementation study |
| title_full_unstemmed | Effectiveness, cost-effectiveness and return on investment of individual placement and support compared with traditional vocational rehabilitation for individuals with severe mental illness in the Netherlands: a nationwide implementation study |
| title_short | Effectiveness, cost-effectiveness and return on investment of individual placement and support compared with traditional vocational rehabilitation for individuals with severe mental illness in the Netherlands: a nationwide implementation study |
| title_sort | effectiveness cost effectiveness and return on investment of individual placement and support compared with traditional vocational rehabilitation for individuals with severe mental illness in the netherlands a nationwide implementation study |
| url | https://bmjpublichealth.bmj.com/content/2/1/e000393.full |
| work_keys_str_mv | AT johannamariavandongen effectivenesscosteffectivenessandreturnoninvestmentofindividualplacementandsupportcomparedwithtraditionalvocationalrehabilitationforindividualswithseverementalillnessinthenetherlandsanationwideimplementationstudy AT philippedelespaul effectivenesscosteffectivenessandreturnoninvestmentofindividualplacementandsupportcomparedwithtraditionalvocationalrehabilitationforindividualswithseverementalillnessinthenetherlandsanationwideimplementationstudy AT frederiekeschaafsma effectivenesscosteffectivenessandreturnoninvestmentofindividualplacementandsupportcomparedwithtraditionalvocationalrehabilitationforindividualswithseverementalillnessinthenetherlandsanationwideimplementationstudy AT jaapvanweeghel effectivenesscosteffectivenessandreturnoninvestmentofindividualplacementandsupportcomparedwithtraditionalvocationalrehabilitationforindividualswithseverementalillnessinthenetherlandsanationwideimplementationstudy AT johannesanema effectivenesscosteffectivenessandreturnoninvestmentofindividualplacementandsupportcomparedwithtraditionalvocationalrehabilitationforindividualswithseverementalillnessinthenetherlandsanationwideimplementationstudy AT miljanavukadin effectivenesscosteffectivenessandreturnoninvestmentofindividualplacementandsupportcomparedwithtraditionalvocationalrehabilitationforindividualswithseverementalillnessinthenetherlandsanationwideimplementationstudy AT wimzwinkels effectivenesscosteffectivenessandreturnoninvestmentofindividualplacementandsupportcomparedwithtraditionalvocationalrehabilitationforindividualswithseverementalillnessinthenetherlandsanationwideimplementationstudy AT marcelspijkerman effectivenesscosteffectivenessandreturnoninvestmentofindividualplacementandsupportcomparedwithtraditionalvocationalrehabilitationforindividualswithseverementalillnessinthenetherlandsanationwideimplementationstudy AT marloesdegraafzijl effectivenesscosteffectivenessandreturnoninvestmentofindividualplacementandsupportcomparedwithtraditionalvocationalrehabilitationforindividualswithseverementalillnessinthenetherlandsanationwideimplementationstudy |