A COST-UTILITY ANALYSIS FOR RETURN-TO-WORK INTERVENTIONS COMPARING ALTERNATIVE METHODS FOR HANDLING MISSING HEALTH-RELATED QUALITY OF LIFE DATA.

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Bibliographic Details
Title:	A COST-UTILITY ANALYSIS FOR RETURN-TO-WORK INTERVENTIONS COMPARING ALTERNATIVE METHODS FOR HANDLING MISSING HEALTH-RELATED QUALITY OF LIFE DATA.
Authors:	NGUYEN, Cindy, BURGER, Emily A., AASDAHL, Lene, MORGANTE, Niccolò, FIMLAND, Marius STEIRO, BJØRNELV, Gudrun MARIA WAALER
Source:	Journal of Rehabilitation Medicine. 2025, Issue 57, p1-9. 10p.
Subjects:	Quality of life, Cost effectiveness, Return to work programs, Occupational rehabilitation, Data management
Abstract:	Objective: Perform a cost-utility analysis for return-to-work interventions with missing health-related quality-of-life (HRQoL) data while transparently demonstrating the impact of different methods of handling missing data on outcomes. Methods: The costs and quality-adjusted life-years over a 2-year period were estimated for 2 return-to-work interventions, inpatient multimodal occupational rehabilitation (I-MORE) and outpatient acceptance and commitment therapy (O-ACT), using a healthcare perspective and a limited societal perspective. Four methods were used to handle the missing HRQoL data: complete case analysis, single imputation, multiple imputation, and linear mixed models. The cost-effectiveness outcomes were expressed as incremental net monetary benefit. Results: The average incremental quality-adjusted life-years comparing I-MORE with O-ACT ranged between -0.001 and 0.330 depending on missingness method. From a healthcare perspective, I-MORE was consistently not cost-effective (incremental net monetary benefits ranged from -€7,094 to -€9,363) while from a limited societal perspective, I-MORE was consistently cost-effective (incremental net monetary benefits ranged from €1,293 to €16,277). Conclusion: While cost-effectiveness findings remained consistent within each analytical perspective, the choice of different missingness methods led to variations in incremental quality-adjusted life-years. Multiple imputation is recommended to handle missing HRQoL data as it is transparent and flexible. However, a thorough investigation of the missing data mechanism should still be conducted. [ABSTRACT FROM AUTHOR]
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Database:	Psychology and Behavioral Sciences Collection

Description
Abstract:	Objective: Perform a cost-utility analysis for return-to-work interventions with missing health-related quality-of-life (HRQoL) data while transparently demonstrating the impact of different methods of handling missing data on outcomes. Methods: The costs and quality-adjusted life-years over a 2-year period were estimated for 2 return-to-work interventions, inpatient multimodal occupational rehabilitation (I-MORE) and outpatient acceptance and commitment therapy (O-ACT), using a healthcare perspective and a limited societal perspective. Four methods were used to handle the missing HRQoL data: complete case analysis, single imputation, multiple imputation, and linear mixed models. The cost-effectiveness outcomes were expressed as incremental net monetary benefit. Results: The average incremental quality-adjusted life-years comparing I-MORE with O-ACT ranged between -0.001 and 0.330 depending on missingness method. From a healthcare perspective, I-MORE was consistently not cost-effective (incremental net monetary benefits ranged from -€7,094 to -€9,363) while from a limited societal perspective, I-MORE was consistently cost-effective (incremental net monetary benefits ranged from €1,293 to €16,277). Conclusion: While cost-effectiveness findings remained consistent within each analytical perspective, the choice of different missingness methods led to variations in incremental quality-adjusted life-years. Multiple imputation is recommended to handle missing HRQoL data as it is transparent and flexible. However, a thorough investigation of the missing data mechanism should still be conducted. [ABSTRACT FROM AUTHOR]
ISSN:	16501977
DOI:	10.2340/jrm.v57.42359