Browsing by Author "Taimela, Elli"

Disability imposes personal suffering but also economic consequences for individuals, employers, and the society. Finding an optimal method for disability prevention can be considered beneficial and increasingly important for a country with a prominent public sector and a weakening labor force participation rate like Finland. Previous studies show evidence of the effectiveness of worksite health promotion programs that target care for employees who face a high risk for disability. Evidence shows positive cost-effectiveness of targeted occupational health interventions in preventing short-term disability but a wider benefit-cost analysis of targeted occupational health interventions with a view on both short-term and long-term disability prevention has not previously been conducted. This study untangles the treatment effect of targeted occupational health interventions on societal net benefits resulted from disability prevention. Short-term disability as a concept is viewed through sickness absence, and long-term disability is represented by the disability benefits granted by the Finnish disability benefit system. The costs of disability preventing actions are limited to health care utilization. The research setting of this study has been observational, and the empirical analysis is conducted as a retrospective review of prospectively collected register data. The data registers cover health and disability related information of over 20,000 employees in Finland. In the main analysis, 1,679 treated employees identified with a high risk for disability are compared to 2,107 untreated high-risk employees. The benefit-cost analysis is constructed with the Average Treatment Effect framework combined with Net Benefits framework. The treatment of the framework of this study is an attendance to a targeted, pre-planned health check after an occupational health survey. The outcome of the framework is the net benefits that result from prevention of sickness absence workdays and granted disability benefits, and the investment costs resulted from health care utilization. The results are formed with Analysis of Covariance. Other methods to conduct the empirical analysis include polynomial regression, Multiple Imputation of Chained Equations, Propensity Scores, and Inverse Probability Weighting. The results of this study show that targeted occupational health interventions are likely to impose positive net benefits to the society. The Average Treatment Effect on the net benefits of high-risk employees, 1,875 euros with a 95% confidence interval from -759 to 4,509 euros (p-value: .155) (ANCOVA), can be considered worthwhile to the society. In the research setting, the net benefits were in practice gained from the prevention of long-term disability. The treatment was not effective on the costs of short-term disability or the total health care utilization costs per employee. Sensitivity analyses indicate that targeted occupational health interventions are not on average effective when predicted to employees without a disability risk.