2012; 54 (6): 276 285 91.6% 1 1 91.6% 2 142 54 196 (1) (2) 6 (3) (4) 60 1 54.2% 91.6% 1 6,226,192 8,418,514 65,945 300,898 ROI 933% 2012; 54 (6): 276 285 doi: 10.1539/sangyoeisei.E12001 1,2) 2) 3) 3 5) 3) 2 II. Cost benefit analysis, Job retention rate, Mental illness, Return to work I. 2012 1 14 2012 8 22 J-STAGE 2012 9 21 103-8324 2 1 1 (e-mail: namba.katsuyuki@chugai-pharm.co.jp) 1. 4,700 1,600 200 900 100 200 17 1 1 2 1 2 2005 1 2011 4 196
91.6% 277 2. 3. 2005 1 2010 7 142 2008 6 2011 4 54 4. Fig. 1 (A) 14 1 28 1 1 2 1 2 3 5. (1) (4) Fig. 1 (B) 6 6) (1) 2 1 24 14 (2) 6 6 2 3 4 6 1 1 6 7 (3) 1 (4)
278 54 2012 Fig. 1. 1 1 6. t R version 2.14.0 Kaplan-Meier Kaplan-Meier Kaplan-Meier (1) (2) 2011 4 (3) 7. (1) 1 1 1.00 0 365 0.00 1.00 1 2010 8,769,285 (2) 2
91.6% 279 Table 1. * p n = 142 n = 54 0.84 96 (67.6%) 38 (70.4%) 46 (32.4%) 16 (29.6%) 36.1 8.3 (23 55) 37.0 9.5 (22 57) 0.46 < 0.01 31 (21.8%) 24 (44.4%) 49 (34.5%) 16 (29.6%) 62 (43.7%) 14 (25.9%) 0.24 56 (39.4%) 20 (37.0%) 54 (38.0%) 15 (27.8%) 10 (7.0%) 3 (5.6%) 7 (4.9%) 5 (9.3%) 3 (2.1%) 4 (7.4%) 4 (2.8%) 4 (7.4%) 1 (0.7%) 2 (3.7%) 1 (0.7%) 0 (0.0%) 4 (2.8%) 1 (1.9%) 2 (1.4%) 0 (0.0%) 168.1 176.1 (1 950) 251.6 231.1 (14 1,142) < 0.01 107.5 167 * t 1 20,000 (3) ROI ROI 100 ROI 100% ROI 100 III. p=0.46 p=0.24 p<0.01 168.1 176.1 1 950 107.5 251.6 231.1 14 1,142 167 Table 1 t p<0.01 1 7 1. 142 54 Table 1 p=0.84 t 2. Kaplan-Meyer Fig. 2 1 92.3% 3 83.0% 6 67.9%
280 54 2012 Fig. 2. * * p<0.01 1 54.2% 2 47.2% 3 42.5% 6 96.3% 1 91.6% 2 87.6% p<0.01 3. 1 0.71 0.96 1 6,226,192 8,418,514 4. Table 2 (A) (B) 1 65,945 300,898 2,582,735 4,012,248 Table 2 (C) 2,648,680 4,313,146 5. 1 2,192,321 234,953 1,664,467 ROI ROI 933% (= 2,192,321 234,953) ROI 132% (= 2,192,321 1,664,457) IV. 1. Table 1
91.6% 281 Table 2. 20 2 13,332 10 2 6,666 1 30 3 7,353 15 2 2,451 10 2 1,634 120 1 9,804 120 1 9,804 30 1 9,999 30 1 2,451 30 1 2,451 65,945 30 12 119,988 15 12 59,994 15 12 14,706 15 12 14,706 120 1 9,804 180 1 14,706 100 1 8,170 60 3 14,706 60 1 4,902 60 1 4,902 60 1 4,902 120 3 29,412 300,898 107.5 2,582,735 167 4,012,248 2. 1 3 Fig. 2 30 7.7% 31 120 14.3% 121 540 26.2%
282 54 2012 3. 1 91.6% 2 87.6% (1) 2) 3) (2) 6 3) 2) 6 6 (3) 5,7,8) (4) Table 4. 60 Table 1 9) 1
91.6% 283 5. 7) ROI 100% 6. 5,8,10) 7. RCT V. (1) (2) 6 (3) 3 (4) 1) 2011. 2) 2009 2009: 23 61. 3) 2011; 26: 197 201. 4) 2011; 19: 145 56. 5) 2011; 26: 9 17. 6) 2012; 3822: 95 121. 7) van Oostrom SH, Heymans MW, de Vet HC, van Tulder MW, van Mechelen W, Anema JR. Economic evaluation of a workplace intervention for sick-listed employees with distress. Occup Environ Med 2010; 67: 603 10. 8) 2010; 52: 267 74. 9) EAP 5 2010; 18: 55 61. 10) 19 2008. Appendix Fig. A1, Fig. A2
284 54 2012 Appendix 1. Appendix 2.
91.6% 285 A Return-to-work Program with a Relapse-free Job Retention Rate of 91.6% for Workers with Mental Illness Katsuyuki Namba 1 1 Chugai Pharmaceutical Co., Ltd., 1 1 Nihonbashi-Muromachi 2-choume, Chuo-ku, Tokyo 203-8324, Japan Objective: We evaluated the relapse-free job retention rate and cost-effectiveness of return-to-work (RTW) programs for workers with mental illness. Method: We retrospectively evaluated a group of 196 employees of a pharmaceutical company in Japan who had taken sick leave because of mental illness. We found that the old RTW program led to 142 employees returning to work and the new RTW program resulted in 54 employees returning to work. In the new program, we introduced the following improvements: evaluation of recovery and readiness to return to work by using the Daily Activity Record Sheet ; planning for RTW with reasonable steps in 6 months; monthly interviews with an occupational health physician, to keep in touch with workers in the RTW process; and arranging a Return-to-Work Coordination Meeting with occupational health specialists, to make reasonable adjustments to a return-to-work plan. Results: The median duration of sick leave was 60 days longer in the new program. The relapse-free job retention rate within 1 year was 54.2% in the old program and was increased to 91.6% in the new program. The old and new programs cost 65,945 yen and 300,898 yen, respectively. The benefits of the old and new programs were 6,226,192 yen and 8,418,514 yen, respectively. The return on investment (ROI) was 933%. Conclusion: The new RTW program is effective at improving the relapse-free job retention rate of workers with mental illness. (San Ei Shi 2012; 54: 276 285)