Original Title: Kosteneffektivität von Kommunikationstrainings für Gesundheitspersonal

Authors' objectives: At the beginning of 2022, the Federal Ministry of Social Affairs, Health, Care and Consumer Protection asked Gesundheit Österreich GmbH for the current state of evidence on the economic effects that can result from improved conversation quality in the interaction between health care staff and patients, specifically regarding the effects of communication training for health care staff, conducted for this purpose. The aim of this rapid assessment was therefore to examine the cost-effectiveness of such training regarding relevant health and process quality outcomes on the basis of published economic evaluations.

Authors' results and conclusions: A total of 18 studies were included: two modelling studies and 16 clinical studies (mostly randomised controlled trials) with collection of cost and resource use respectively. Six calculated a cost-effectiveness ratio, four a cost-utility ratio and three a cost-benefit ratio. The others reported costs and effects separately. Most studies covered specific disease areas or topics (e.g. antibiotic prescriptions, behaviour change, patient groups with impaired speech). The communication training interventions varied widely in scope and design. Eight studies had to be excluded from closer examination because communication training was not considered as an isolated intervention. On the cost side, mainly direct costs in the health system were considered. Not all studies included all of the relevant cost categories. Of the ten studies that examined communication training as a separate intervention, three were from the US, the rest from Europe. Eight studies showed that communication training can improve health-related outcomes. Five of them concluded that it not only achieved higher effects, but also led to lower overall costs than a comparable approach without communication training. In one study, the benefits to be gained were offset by costs of around £96,000 per quality-adjusted life year, and in two, not all relevant cost categories were collected. Two studies found no improvement or even a worsening of health-relevant outcomes with the additional use of communication training compared to the comparative intervention, while at the same time the total costs were similarly high or higher.

Authors' recommendations: Communication training for health care professionals is a complex intervention of the health care sector and can have health effects on both patients and the professionals involved. Also, a multiplier effect may occur. The included studies took this into account in very different ways. Mostly, however, the focus was on the patient-side effects, and most of the time only effects within the included study population were examined. Although individual study results are not transferable between different countries and settings and some inconsistency in the results should not surprise due to the large heterogeneity, half of the publications clearly showed positive economic results in favour of the intervention. A limitation for this rapid assessment is that, for reasons of available resources, very abbreviated methodological procedures were used.

Authors' methods: The systematic literature search was conducted on 7 and 9 March 2022 in the databases CINAHL, EconLit, APA PsycInfo and MEDLINE. Keywords and MeSH terms were used related to: training and education, communication and health worker-patient relationship, health professions, cost (benefit) analysis. One reviewer screened the results for full publications that met the criteria of the research question and were available in English or German. The search was supplemented by a hand search. One reviewer extracted the data from each of the identified economic studies; a systematic assessment of the study quality was not carried out.

Project Status: Completed

Year Published: 2022

URL for published report: https://jasmin.goeg.at/2387/

English language abstract: An English language summary is available

Publication Type: Rapid Review

Country: Austria

Organisation Name: Gesundheit Osterreich GmbH

Contact Address: Gesundheit Osterreich GmbH, Stubenring 6, 1010 Vienna, Austria tel.: +43 1 515 61-0 fax: +43 1 513 84 72

Contact Name: Heidi Stürzlinger

Contact Email: Heidi.stuerzlinger@goeg.at