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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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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]
Copyright of Journal of Rehabilitation Medicine is the property of Foundation of Rehabilitation Medicine and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: 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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  Data: <searchLink fieldCode="DE" term="%22Quality+of+life%22">Quality of life</searchLink><br /><searchLink fieldCode="DE" term="%22Cost+effectiveness%22">Cost effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Return+to+work+programs%22">Return to work programs</searchLink><br /><searchLink fieldCode="DE" term="%22Occupational+rehabilitation%22">Occupational rehabilitation</searchLink><br /><searchLink fieldCode="DE" term="%22Data+management%22">Data management</searchLink>
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  Data: 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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  Data: <i>Copyright of Journal of Rehabilitation Medicine is the property of Foundation of Rehabilitation Medicine and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.2340/jrm.v57.42359
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      – SubjectFull: Return to work programs
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              Text: 2025
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