The economic impact of workplace wellness programmes in Canada
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Background The economic benefits of workplace wellness programmes (WWPs) are commonly cited as a reason for employers to implement such programmes; however, there is limited evidence outside of the US context exploring their economic impact. US evidence is less relevant in countries such as Canada with universal publicly funded health systems because of the lower potential employer savings from WWPs. Aims To conduct a systematic review of the Canadian literature investigating the economic impact of WWPs from an employer perspective. The quality of that evidence was also assessed. Methods We reviewed literature which included analyses of four economic outcomes: return on investment calculations; cost-effectiveness or cost-benefit analyses; valuations of productivity, turnover, absenteeism and/or presenteeism costs; and valuations of health care utilization costs. We applied the British Medical Journal (BMJ) Economic Evaluation Working Party Checklist to evaluate the quality of this evidence. Results Eight studies met the inclusion criteria. Although the studies showed that WWPs generated economic benefits from an employer perspective (largely from productivity changes), none of the reviewed studies were in the high-quality category (i.e. fulfilled at least 75% of the checklist criteria) and most had severe methodological issues. Conclusions Though the Canadian literature pertaining to the economic impact of WWPs spans over three decades, robust evidence on this topic remains sparse. Future research should include a comparable control group, a time horizon of over a year, both direct and indirect costs, and researchers should apply analytical techniques that account for potential selection bias.