Short-term effectiveness of face-to-face periodic occupational health screening versus electronic screening with targeted follow-up: results from a quasi-randomized controlled trial in four Belgian hospitals.

Abstract

In many countries, organisations are legally obliged to have occupational physicians screen employees regularly. However, this system is time-intensive, and there may be more cost-effective alternatives. Our objective is to compare the short-term effectiveness of periodic occupational health screening of hospital employees by an occupational physician with a system of electronic screening with targeted follow-up. A randomized controlled trial was set up among personnel of four Belgian hospitals, with three measurement moments between June 2019 and December 2020, to compare differences in self-assessed health, healthcare use, productivity and intermediate outcomes over 19 months. Mixed effects models were used to assess differences in effectiveness. Superiority and non-inferiority post-hoc tests were used as a robustness check. The experiment coincided with the first two COVID-19 waves during which hospital employees were exposed to an exceptional period of occupational stress. In total, 1077 employees (34% of the target population) participated. Although we observed some immediate effects of the intervention (less trust in the physician, absenteeism, and healthcare use), all these effects disappeared over time. After 19 months, including two waves of COVID-19 hospitalizations, no significant differences were observed between employees screened through face-to-face contact and those screened electronically. Our study finds no indication that, in the short-term, substituting physician screening of the workforce with a quicker survey-based screening with targeted follow-up has different effects on the studied endpoints. However, as health and disease are often the result of a long-term process, more evidence is needed to determine long-term effects.