Bridging the gap between the economic evaluation literature and daily practice in occupational health: a qualitative study among decision-makers in the healthcare sector

Implementation Science

Marieke F van Wier²  Allard J van der Beek⁵  Maurits W van Tulder²  Paulien M Bongers⁶  Anna Sarnocinska-Hart⁴  Laurie Clune³  Emile Tompa¹  Johanna M van Dongen⁵ 

[1] Dalla Lana School of Public Health, University of Toronto, 155 College Street Health Science Building, 6th floor, Toronto, Ontario M5T 3M7, Canada;Department of Epidemiology and Biostatistics and the EMGO + Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands;Faculty of Nursing, University of Regina, Education Building, Room 614, Regina, Saskatchewan, S4S 0A2, Canada;Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, Ontario, M5G 2E9, Canada;Department of Public and Occupational Health and the EMGO + Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands;TNO Healthy Living, Polarisavenue 151, 2132 JJ, Hoofddorp, the Netherlands

关键词: Evidence-based practice;    Information needs;    Decision-making process;    Interventions;    Occupational health and safety;   

Others  :  813630
DOI  :  10.1186/1748-5908-8-57

 received in 2013-01-04, accepted in 2013-05-31,  发布年份 2013

【 摘 要 】

Background

Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific evidence should meet the needs of decision-makers. As a first step in bridging the gap between the economic evaluation literature and daily practice in occupational health, this study aimed to provide insight into the occupational health decision-making process and information needs of decision-makers.

Methods

An exploratory qualitative study was conducted with a purposeful sample of occupational health decision-makers in the Ontario healthcare sector. Eighteen in-depth interviews were conducted to explore the process by which occupational health decisions are made and the importance given to the financial implications of OHS interventions. Twenty-five structured telephone interviews were conducted to explore the sources of information used during the decision-making process, and decision-makers’ knowledge on economic evaluation methods. In-depth interview data were analyzed according to the constant comparative method. For the structured telephone interviews, summary statistics were prepared.

Results

The occupational health decision-making process generally consists of three stages: initiation stage, establishing the need for an intervention; pre-implementation stage, developing an intervention and its business case in order to receive senior management approval; and implementation and evaluation stage, implementing and evaluating an intervention. During this process, information on the financial implications of OHS interventions was found to be of great importance, especially the employer’s costs and benefits. However, scientific evidence was rarely consulted, sound ex-post program evaluations were hardly ever performed, and there seemed to be a need to advance the economic evaluation skill set of decision-makers.

Conclusions

Financial information is particularly important at the front end of implementation decisions, and can be a key deciding factor of whether to go forward with a new OHS intervention. In addition, it appears that current practice in occupational health in the healthcare sector is not solidly grounded in evidence-based decision-making and strategies should be developed to improve this.

【 授权许可】

   
2013 van Dongen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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