Effectiveness and economic impact of interventions targeting healthcare personnel: a systematic review of return on investment

Abstract

Objectives To evaluate and critically interpret economic evidence on workplace interventions targeting healthcare personnel, distinguishing return on investment from related economic evaluation approaches and grouping interventions by underlying mechanisms. Methods PubMed, Scopus, and Web of Science were searched for peer-reviewed studies published from 2006 to 2024. Eligible empirical studies reported return on investment, benefit-cost ratios, net savings, cost-effectiveness metrics, societal returns, or comparable monetized outcomes for workplace interventions involving healthcare workers. Methodological quality was assessed using CHEERS and ECOBIAS. Results Twenty-eight studies met the inclusion criteria. Most reported positive or potentially favorable economic returns, particularly for preventive health measures, workplace mental health and disability-management programs, and educational or human-capital initiatives. Findings were highly context-dependent. Some interventions produced modest, neutral, or unfavorable returns, while the highest estimates often came from model-based analyses or broad societal extrapolations. Comparability was limited by differences in perspective, time horizon, monetization assumptions, health-system structure, labor costs, and implementation. Conclusion Evidence supports workplace interventions as part of health workforce strategies, but return on investment should not be used as a stand-alone decision criterion. Future evaluations require standardized methods, transparent assumptions, and explicit perspectives and time horizons.