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Economic Evaluation of Interventions for Occupational Health and Safety: Developing Good Practice

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Overview

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.

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Editorial Reviews

Doody's Review Service
Reviewer: J. Thomas Pierce, MBBS PhD(Navy Environmental Health Center)
Description: This book lays the foundation for a systematic approach to identifying barriers to high quality occupational safety and health research. Using the language of health economics, the editors painstakingly explain how occupational health and safety research could become economically relevant.
Purpose: In the concluding chapter, the editors synthesize across summaries, conclusions, challenges, and recommendations to lay out the path forward through the use of a reference case.
Audience: The audience likely will be a mix of practitioners and academics who study the process and implications of interventions in occupational safety and health.
Features: The book is a bit more of a prospectus for important steps of this nature rather than a review of carefully documented studies. The short answer is they don't presently exist. Early on, the editors ask, "What is a little more health and safety worth?" then go about fairly and accurately addressing the question. It is possible that this kind of exposition is old hat to the health economics crowd, but that is hardly the case for safety and health researchers or practitioners. There has likely never been a time that economic evaluation has been more relevant. It is incumbent upon us as readers and, more importantly, as practitioners, to get on board with what this book is discussing. In three parts, the authors and editors set the scene and put it in context (including conceptualization, critical reviews, lessons from health technology), identify specific topics (including study designs, types of analysis and costs), and eventually reach conclusions.
Assessment: For most readers, the critical dimension is sufficient knowledge of, "What a little more health and safety might be worth." These authors and editors can help the rest of us get there! The way forward is limited, given an absence of this type of knowledge. This book develops an important perspective and is must reading.
From The Critics
Reviewer: J. Thomas Pierce, MBBS PhD (Navy Environmental Health Center)
Description: This book lays the foundation for a systematic approach to identifying barriers to high quality occupational safety and health research. Using the language of health economics, the editors painstakingly explain how occupational health and safety research could become economically relevant.
Purpose: In the concluding chapter, the editors synthesize across summaries, conclusions, challenges, and recommendations to lay out the path forward through the use of a reference case.
Audience: The audience likely will be a mix of practitioners and academics who study the process and implications of interventions in occupational safety and health.
Features: The book is a bit more of a prospectus for important steps of this nature rather than a review of carefully documented studies. The short answer is they don't presently exist. Early on, the editors ask, "What is a little more health and safety worth?" then go about fairly and accurately addressing the question. It is possible that this kind of exposition is old hat to the health economics crowd, but that is hardly the case for safety and health researchers or practitioners. There has likely never been a time that economic evaluation has been more relevant. It is incumbent upon us as readers and, more importantly, as practitioners, to get on board with what this book is discussing. In three parts, the authors and editors set the scene and put it in context (including conceptualization, critical reviews, lessons from health technology) , identify specific topics (including study designs, types of analysis and costs) , and eventually reach conclusions.
Assessment: For most readers, the critical dimension is sufficient knowledge of, "What a little more health and safety might be worth." These authors and editors can help the rest of us get there! The way forward is limited, given an absence of this type of knowledge. This book develops an important perspective and is must reading.
Read More Show Less

Product Details

  • ISBN-13: 9780199533596
  • Publisher: Oxford University Press, USA
  • Publication date: 10/15/2008
  • Pages: 256
  • Product dimensions: 6.10 (w) x 9.10 (h) x 0.70 (d)

Meet the Author

Emile Tompa is Adjunct Assistant Professor in the Department of Economics at McMaster University. He has an MBA from the University of British Columbia, an MA in Economics from the University of Toronto, and a PhD in Economics from McMaster University. Tompa's current research agenda is focused on the economic evaluation of workplace interventions and the behavioural consequences of insurance and regulatory mechanisms for occupational health and safety. In the area of economic evaluation, he has completed a systematic review of workplace intervention studies with economic analyses, and has undertaken several evaluations of participatory ergonomics interventions. In the area of insurance and regulatory mechanisms, he is undertaking research on experience rating, occupational health and safety regulation, and the adequacy and equity of workers' compensation benefits. He is the academic lead of a five-year community-university research initiative on the consequences of work injury. Anthony Culyer has been at York since 1969 where his main roles have been as Assistant Director of the (then) Institute for Social and Economic Research, Head of the Department of Economics and Related Studies, Pro-Vice-Chancellor and then Deputy Vice-Chancellor of the University. He currently holds the Ontario chair in Health Policy and System Design at the University of Toronto and is a Professor of Economics at the University of York, England. He chairs the R&D Committee of the National Institute for Health and Clinical Excellence, the Policy and Editorial Committees of the Office of Health Economics, and the Research Advisory Council of the Workplace Safety and Insurance Board in Ontario. Roman Dolinschi holds a Master's in Economics from the University of Toronto. Dolinschi has a strong interest in the economic evaluation of occupational health and safety interventions. He has recently completed several economic evaluations of occupational health and safety interventions and a systematic review of workplace intervention studies with economic evaluations. Dolinschi is also actively involved in three research themes: labour-market experiences and health; the behavioural consequences of insurance and regulation in occupational health and safety; and workplace-based occupational health and safety interventions.

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Table of Contents

1 The broad conceptualization of work and health Cameron Mustard Mustard, Cameron 3

2 What is a little more health and safety worth? Anthony J. Culyer Culyer, Anthony J. Benjamin C. Amick III Amick, Benjamin C., III Audrey Laporte Laporte, Audrey 15

3 A critical review of the application of economic evaluation methodologies in occupational health and safety Emile Tompa Tompa, Emile Roman Dolinschi Dolinschi, Roman Karen Niven Niven, Karen Claire de Oliveira de Oliveira, Claire 37

4 Lessons from health technology assessment Anthony J. Culyer Culyer, Anthony J. Mark Sculpher Sculpher, Mark 51

5 Lessons from the literature on valuing reductions in physical risk Richard Cookson Cookson, Richard Peter Dorman Dorman, Peter 71

6 The institutional and regulatory settings for occupational health and safety : an international survey Ulrike Hotopp Hotopp, Ulrike John Mendeloff Mendeloff, John Sandra Sinclair Sinclair, Sandra Emile Tompa Tompa, Emile Dorte Eltard Eltard, Dorte Birgit Koeper Koeper, Birgit Alan Clayton Clayton, Alan 93

7 Workplace-researcher relationship : early research strategy and avoiding the 'data dearth' Benjamin C. Amick III Amick, Benjamin C., III Phil Bigelow Bigelow, Phil Donald C. Cole Cole, Donald C. 117

8 Study design William Gnam Gnam, William Lynda Robson Robson, Lynda Thomas Kohstall Kohstall, Thomas 135

9 Kind of analysis and decision rule Jeffrey S. Hoch Hoch, Jeffrey S. Carolyn S. Dewa Dewa, Carolyn S. 147

10 Costs Audrey Laporte Laporte, Audrey Roman Dolinschi Dolinschi, Roman Emile Tompa Tompa, Emile 165

11 Consequences Emile Tompa Tompa, Emile Roman Dolinschi Dolinschi, Roman Claire de Oliveira de Oliveira, Claire 179

12 Adjusting for timepreference and addressing uncertainty William Gnam Gnam, William Michel Grignon Grignon, Michel Roman Dolinschi Dolinschi, Roman 201

13 Equity Anthony J. Culyer Culyer, Anthony J. Emile Tompa Tompa, Emile 215

14 Suggestions for a reference case Emile Tompa Tompa, Emile Anthony J. Culyer Culyer, Anthony J. Roman Dolinschi Dolinschi, Roman 235

Glossary 245

Bibliography 267

Author index 283

Subject index 287

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