Economic evaluation of interventions for occupational health and safety: developing good practice
Undertaking economic evaluations of workplace-based occupational health and safety interventions can be difficult, reflected by the significant lack of literature, evidence and guidance on the subject. Particular difficulties include: complex labour legislation; differences in the perception of health risks associated with work experiences amongst workplace parties and policy makers; the burden of costs and consequences being borne by different stakeholders in the system; conflicting incentives and priorities between the multiple stakeholders; lack of consensus about what ought to count as a benefit or cost of intervening or not intervening; multiple providers of indemnity and medical care coverage; and industry-specific human resources practices making it difficult to identify all work-related illnesses and injuries. In addition, most health economics methods books are designed for use in a clinical setting, which cannot be adapted for the workplace setting. In the face of such barriers, it is not surprising that few studies of occupational health and safety interventions contain an economic evaluation. This book aims to lay the foundations for a systematic methodology of economic evaluation of workplace interventions, by identifying the main barriers to research of high quality and practical relevance, and proposing a research strategy to remedy these weaknesses. Context chapters provide a wealth of background material ranging from a presentation of the broad conceptualization of work and health, to suggestions for strategies in confronting the dearth of data often experienced by occupational health and safety researchers. They take into account the varying institutional and regulatory approaches in different international jurisdictions. Specific topic chapters delve into the principles and application of economic evaluation methods relevant to this setting: study design, type of analysis, costs, consequences, uncertainty, and equity are all covered, providing guidance on analytical and decision making challenges. The concluding chapter synthesizes the summaries, conclusions, challenges and recommendations from across the book, presenting these in a reference case