Economic evaluation of peer support programs: addressing the second victim phenomenon in the german healthcare system
- Autores: Hannah Roesner
- Directores de la Tesis: José Joaquín Mira Solves (dir. tes.)
- Lectura: En la Universidad Miguel Hernández de Elche ( España ) en 2025
- Idioma: español
- Tribunal Calificador de la Tesis: Susanna Tella (presid.), Daniel Lloret Irles (secret.), Bojana Knezevic (voc.)
- Programa de doctorado: Programa de Doctorado en Deporte y Salud por la Universidad Miguel Hernández de Elche
- Materias:
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- Resumen
Healthcare systems worldwide, including Germany's, face critical workforce challenges, such as high rates of burnout, absenteeism, and turnover among medical and nursing staff. A key contributor to these issues is the Second Victim Phenomenon (SVP), in which healthcare workers (HCWs) are negatively impacted by adverse patient events, unintentional medical errors, or patient harm. SVP has been associated with reduced job performance, increased sick leave, and higher rates of staff turnover, resulting in substantial financial burdens on healthcare institutions. While peer support programs (PSPs) have been shown to mitigate the negative effects of SVP, their economic impact has not been thoroughly examined. Understanding the financial impact of PSPs is essential for designing strategies that improve workforce retention and support the long-term sustainability of healthcare systems.
This doctoral thesis aims to assess the financial implications of PSPs in mitigating the effects of the SVP on HCWs with a focus on reducing absenteeism and improving staff retention. To achieve this objective, two correlational studies were conducted to evaluate the economic impact of PSPs within the German healthcare system.
Both studies used a conservative approach and employed economic evaluation methods to quantify the financial burden of SVP and the potential cost savings associated with PSP implementation. In Study I, a Markov model was utilized to compare cost scenarios with and without PSPs over a one-year period in a German scenario hospital with 1,000 employees. Direct costs, including absenteeism and staff turnover, were analyzed. Study II broadened the scope and assessed the national economic implications of PSPs by employing a comprehensive methodological approach and using data from the SeViD studies, which examined the prevalence and time of recovery of SVP among German physicians and nurses. Economic impact assessments were conducted to estimate the potential cost savings associated with implementing a PSP.
The results of both studies highlight the significant financial benefits of implementing PSPs to mitigate SVP among HCWs in Germany. At the hospital level, PSPs have been shown to decrease expenses associated with absenteeism and staff turnover, resulting in average cost saving of €6,672 per HCW and total annual savings of approximately €6.67 million in the hospital scenario.
Staff turnover decreased from 14.3% to 5.8% and absenteeism declined moderately with sick days decreasing from 6,766 to 6,141 annually. On a national level, absenteeism and staff replacement costs amount to €1.56 billion annually for physicians and €1.87 billion for nurses.
Implementing a nationwide PSP could significantly reduce these expenses by lowering absenteeism and staff turnover, with projected savings of €1.55 billion per year for the healthcare sector.
This doctoral thesis fills a critical gap in the literature by quantifying the economic burden of SVP and assessing the cost-effectiveness of PSPs in Germany. The economic analyses conducted in this thesis provide compelling evidence that structured peer support initiatives yield significant financial benefits. Beyond substantial cost savings, PSPs play a vital role in strengthening the healthcare workforce by fostering a supportive environment that enhances staff well-being, patient safety, and institutional stability. The findings of this thesis highlight the need for nationwide PSP implementation and greater awareness of SVP's impact on HCWs and institutions. Investing in HCWs well-being not only improves workforce retention but also helps hospitals balance financial sustainability with high-quality patient care, ultimately contributing to a more resilient healthcare system.
