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A revised cost-benefit analysis tool capable of analysing the effects of vocational rehabilitation

Brown, TM




Sickness absence and presenteeism are estimated to cost the UK economy £100 billion a year. Vocational Rehabilitation (VR) has been advocated within the UK, and internationally, as an effective means to address ill-health within the workplace; however, there is a paucity of research exploring its cost-effectiveness. A robust economic model, using evidence-based assumptions would assist in developing an evidence-base, as well as enable organisations to assess the cost-effectiveness of VR services they utilise. Within the UK, there is no economic tool for evaluating VR for the employed population. This research adapted an existing cost-benefit analysis (CBA) model creating a new practical CBA tool able to capture and analyse the effects of VR from an organisational perspective.

A mixed methods explanatory sequential design, with two distinctly independently yet interactive phases was used. The quantitative phase consisted of three elements, firstly a systematic review to develop the outcomes in the CBA tool, namely sickness absence due to musculoskeletal and mental health conditions, presenteeism, and turnover. In order to develop these outcomes, new reference and intervention cases specifically for VR interventions were created using a mirror image of the traditional CBA model. Secondly, in order to generate data to test the new CBA tool, two pre-experimental repeated-measures within-group (time series) studies were conducted, exploring two in-house VR services, for employees with musculoskeletal and mental health conditions. Lastly, the new CBA tool was implemented and tested, and sensitivity and scenario analysis of the results were conducted. The qualitative phase consisted of an analysis of a focus group of VR service personnel to explore the practical utility of the new CBA tool.

This research produced a practical CBA tool, capable of analysing the costs and benefits of VR services. The scenario and sensitivity analysis indicated that in order for the CBA results to be robust sufficient sample sizes would be needed. Organisation 1’s results (Net present value (NPV) = -£84,122.01, BCR = 0.05, n = 127) indicated that the VR service was not cost effective. Organisation 2’s results (NPV = £4,940.61, BCR = 1.17%, n = 43) indicate that the VR service was cost effective. Organisation 1 did not include turnover data and had known errors in the sickness absence data, which may account for this difference. The CBA tool was well-received by the VR personnel (n = 4), indicating that it was user-friendly, would help with objectively assessing the economic value of VR in different settings, and assist service design through identifying where to allocate resources. The new CBA tool is still in its early stages and can be developed further as the evidence-base in VR grows. This model lays the foundations for organisations to assess the costs/benefits of the services they provide or receive and for researchers to use in their economic evaluations of VR interventions.


Brown, T. (in press). A revised cost-benefit analysis tool capable of analysing the effects of vocational rehabilitation. (Thesis). University of Salford

Thesis Type Thesis
Acceptance Date Oct 25, 2018
Deposit Date Sep 25, 2018
Publicly Available Date Sep 25, 2018