Stress management intervention for leaders of SMEs in Germany - a health-economic perspective

Introduction:

Leaders in small and medium-sized enterprises (SMEs) are exposed to a twofold burden of high occupational stress and high responsibility, leading to a higher risk of stress induced health effects, like cardiovascular diseases, depression or burnout. Preventing these with a stress intervention could play a significant role in reducing costs for SMEs as well as in the healthcare sector. The objective of this health-economic evaluation was to examine the cost-effectiveness of the intervention from a societal and employers’ point of view.

 

Method:

Data for 94 participants in the intervention group and 100 participants in the control group was collected before the intervention, after six and twelve months using the German version of the Client Sociodemographic and Service Receipt Inventory (CSSRI-D). Calculation of quality-adjusted life years (QALYs) was measured with EQ-5D-5L. The current German utility values set was used. The Cost-utility ratio (ICUR) was calculated and non-parametric bootstrapping was used to take into account stochastic uncertainty.

 

Results:

Average annual costs of overall health care use for the intervention group amount 2.189,56 € (SD 3.065,76 €) and 1.858,87 € (SD 3.166,69€) for the control group ICUR reached -92.603,45. The ICUR is located in the upper left quadrant and the variance reveals a distribution over all four quadrants of the cost-effectiveness plane without an estimable 95% confidence interval indicating an inconclusive result of the cost-utility analysis (CUA).

  

 

Discussion-conclusion:

The inconclusive result of the cost-utility analysis due to the stochastic uncertainty made it impossible to draw clear conclusions regarding the cost effectiveness of the stress intervention. Since stress related diseases are a major health risk and a financial burden further studies are needed.