bims-cieche 2025-07-13 papers

Issue of 2025–07–13
four papers selected by
Jonas Stefaan Steel, IDEWE

J Med Econ. 2025 Dec;28(1): 1061-1074

Economic impact of a digital tobacco cessation program: healthcare savings and productivity gains in a self-insured manufacturing company.

Matthew Brault, David B Rein, Amanda L Graham.

OBJECTIVE: To quantify the return on investment of a digital tobacco cessation program from an employer perspective by analyzing healthcare cost savings and productivity gains in a real-world workplace setting.
METHODS: This quasi-experimental study analyzed medical claims data from a self-insured US manufacturing company, comparing healthcare costs between program enrollees (n = 153) and matched non-enrollees (n = 3,943) over a 12-month post-enrollment period. Exact and propensity score matching were used to address selection bias, followed by difference-in-differences analysis to control for temporal trends. The study population included employees and spouses continuously enrolled in the company health plan from November 2019 through December 2023. Administrative claims data captured all healthcare services, while productivity benefits were estimated through simulation modeling using published parameters and conservative assumptions for absenteeism reduction and presenteeism improvements. The analysis adopted an employer perspective with a 1-year time horizon, incorporating both direct medical cost savings and indirect productivity gains.
RESULTS: Program enrollees demonstrated $950 lower annual healthcare costs compared to matched non-enrollees within the first year of enrollment (95% CI = -$2,022-$122; p = 0.083 using difference-in-differences analysis). Productivity gains contributed an additional $960 per enrollee (95% CI = $446-$1,614), resulting from reduced absenteeism and improved workplace performance. Combined healthcare and productivity savings totaled $1,910 per participant (95% CI = $694-$3,158). At a program cost of $200 per participant, this yielded a return on investment of $9.55 for every dollar invested (95% CI = $3.47-$15.79). Sensitivity analyses confirmed robust positive returns across varying assumptions about abstinence rates and productivity parameters.
CONCLUSIONS: Using rigorous econometric methods to minimize confounding bias, this analysis demonstrates substantial employer cost savings from implementing a digital tobacco cessation program. The nearly 10-fold return on investment, driven by both healthcare savings and productivity improvements, provides compelling economic evidence for employers evaluating digital health solutions in workplace wellness programs.

Keywords: I12; I19; Smoking cessation; cost-benefit analysis; health expenditure; matching; propensity score; tobacco cessation

DOI: https://doi.org/10.1080/13696998.2025.2529721

Front Public Health. 2025 ;13 1592601

A review of the business case for workforce nutrition initiatives.

Evert-Jan Quak, Ayako Ebata, Inka Barnett.

Undernutrition and malnutrition remain persistent challenges in low-and middle-income countries (LMICs), especially among workers in labour-intensive sectors. Workplace nutrition programmes (WNPs) have shown promising health benefits, but evidence on their business impact remains scarce-particularly in LMIC contexts. This review examines whether WNPs generate measurable business outcomes that could incentivise employer investment. Using a structured literature review (SLR) approach, we systematically analysed 24 relevant studies-10 systematic reviews and 14 empirical papers. Search terms targeted nutrition-related workplace interventions and business outcomes, including productivity, absenteeism, and return on investment. Searches were conducted across Scopus, ScienceDirect, Google Scholar, and grey literature sources. Studies were included if they assessed business-related outcomes of health or wellness interventions with nutrition components. Only four studies were based in LMICs; the remaining 20 were from high-income countries (HICs), underscoring a major evidence gap. Despite this, two main impact pathways emerged: (1) healthier diets improve workers' concentration and energy, reducing absenteeism and saving costs; and (2) improved nutrition enhances motivation, productivity, and work quality, which may increase sales and revenue. The first pathway is more relevant to skilled workers who are harder to replace, unlike the easily replaceable labour force common in many LMIC industries. In the second pathway, while improved nutrition may boost productivity, structural barriers-such as limited bargaining power in global supply chains-can prevent these gains from leading to better pay for workers. This review outlines key pathways through which improved worker nutrition may benefit businesses and identifies critical gaps in the evidence. It also proposes outcome indicators relevant to private sector stakeholders in LMICs, helping to guide future empirical research.

Keywords: absenteeism; business; cost savings; low-and middle-income countries; malnutrition; nutrition; productivity; work

DOI: https://doi.org/10.3389/fpubh.2025.1592601

Int J Nurs Stud. 2025 Jun 20. pii: S0020-7489(25)00155-5. [Epub ahead of print]170 105146

Organizational return on investment in nursing: A systematic review.

Olga Yakusheva, Kathryn Lee, Alissa V Fial, Marianne E Weiss.

BACKGROUND: High-quality nursing care is crucial for healthcare quality and safety, yet there's limited understanding of the business case for investing in nursing from an organizational perspective. This study seeks to address this evidence gap by identifying and synthesizing data on the organizational return on investment in nursing human capital, considering initial investment costs and the resulting impact on production costs and revenue.
METHOD: We conducted a systematic review using four databases (PubMed, CINAHL, EconLit, Web of Science) to find nursing human capital studies from January 1990 to June 2024. Studies were eligible for inclusion if they examined nurses providing care within healthcare delivery organizations or systems and reported financial outcomes, were written in English, and used inferential statistics. The systematic review was registered in Prospero (CRD 42023462385).
RESULTS: From 37,132 search results, the final analysis included 59 studies from North America, Europe, Asia, and Australia/New Zealand. Thirty-two studies focused on nurse staffing, 14 on skill mix, and 8 on nurse education and experience. Most studies reported improved patient and nurse outcomes, reduced turnover, and lower production costs. However, few studies fully accounted for initial investment costs and their subsequent impact on production and revenue, complicating inferences about organizational return on investment. Only 12 studies conducted complete return on investment evaluations, covering 19 nursing variables: 11 evaluated nurse staffing (2 positive, 4 negative, 5 neutral), 3 examined skill mix (1 positive, 1 negative, 1 neutral), and 1 focused on increased education (neutral). Two studies examined the work environment (1 positive, 1 negative) and two evaluated programmatic interventions (1 positive, 1 neutral).
CONCLUSION: Based on the findings, we conclude that the existing evidence of organizational financial return on investment in nursing is limited in scope and contradictory. Although nurses improve patient outcomes and are valued by consumers, the lack of a strong organizational business case restricts organizational investments in their nurse employees' growth and development. Future research should evaluate organizational return on investment in nursing to better inform decisions on nurse employment and utilization.

Keywords: Cost; Economics; Health care; Human capital; Investment; Nursing; Organizations; Profit; ROI; Return on investment; Revenue; Systematic review; Value; Workforce

DOI: https://doi.org/10.1016/j.ijnurstu.2025.105146

Sci Rep. 2025 Jul 05. 15(1): 24014

Assessing the burden of dermatological diseases on work life from a gender perspective.

Martina Padovan, Bianca Benedetta Benincasa, Salvatore Panduri, Valentina Dini, Riccardo Morganti, Riccardo Marino, Poupak Fallahi, Marco Romanelli, Rudy Foddis.

This study investigates the impact of dermatological diseases on work activity, with a particular focus on potential gender differences. The primary objectives are to evaluate the severity of these conditions and their implications for job performance, productivity, and non-work-related daily activities. A cross-sectional analysis was conducted on employed patients with dermatological conditions between September 2021 and November 2023. Participants completed a new self-reported survey, including the Dermatological Diseases Work Impact Questionnaire (2DWIQ), along with two validated tools: the Work Ability Score (WAS) and the Work Productivity and Activity Impairment questionnaire. Participants were stratified by occupational category (blue- and white-collar workers). Statistical analyses were adjusted for factors influencing questionnaire outcomes, and the internal reliability of the 2DWIQ was assessed using Cronbach's α. The study included 417 participants (231 men and 186 women) affected by a dermatological disease primarily atopic dermatitis, psoriasis, and hidradenitis suppurativa. Women reported significantly higher levels of absenteeism, overall work impairment, and activity impairment compared to men. Additionally, they had lower WAS scores, indicating poorer work ability. Dermatological diseases have a greater impact on women, affecting both their work performance and daily lives. Gender-specific interventions are crucial to reducing the physical and psychological burden of these conditions and improving occupational health management.

Keywords: Dermatological diseases; Gender differences; Occupational health; White- and blue-collar workers; Work ability; Work productivity

DOI: https://doi.org/10.1038/s41598-025-07804-x