Feeling Healthy? A Survey of Physical and Psychological Wellbeing of Students from Seven Universities in the UK

University students’ physical and psychological health and wellbeing are important and comprise many variables. This study assessed perceived health status in addition to a range of physical and psychological wellbeing indicators of 3,706 undergraduate students from seven universities in England, Wales and Northern Ireland. We compared differences in these variables across males and females, and across the participating universities. The data was collected in 2007–2008. A self-administered questionnaire assessed socio-demographic information (e.g., gender, age), self-reported physical and psychological health data, as well as questions on health awareness, health service use, social support, burdens and stressors and university study related questions. While females generally reported more health problems and psychological burdens, male students felt that they received/had fewer persons to depend on for social support. The comparisons of health and wellbeing variables across the different universities suggested some evidence of ‘clustering’ of the variables under study, whereby favourable situations would be exhibited by a cluster of the variables that is encountered at some universities; and conversely, the clustering of less favourable variables as exhibited at other universities. We conclude that the level of health complaints and psychological problems/burdens is relatively high and calls for increased awareness of university administrators, leaders and policy makers to the health and well-being needs of their students. The observed clustering effects also indicated the need for local (university-specific) health and wellbeing profiles as basis and guidance for relevant health promotion programmes at universities

The cost effectiveness of NHS physiotherapy support for occupational health (OH) services

Background: Musculoskeletal pain is detrimental to quality of life (QOL) and disruptive to activities of daily living. It also places a major economic burden on healthcare systems and wider society. In 2006, the Welsh Assembly Government (WAG) established a three tiered self-referral Occupational Health Physiotherapy Pilot Project (OHPPP) comprising: 1.) telephone advice and triage, 2.) face-to-face physiotherapy assessment and treatment if required, and 3.) workplace assessment and a return-to-work facilitation package as appropriate. This study aimed to evaluate the feasibility and cost-effectiveness of the pilot service. Methods: A pragmatic cohort study was undertaken, with all OHPPP service users between September 2008 and February 2009 being invited to participate. Participants were assessed on clinical status, yellow flags, sickness absence and work performance at baseline, after treatment and at 3 month follow up. Cost-effectiveness was evaluated from both top-down and bottom-up perspectives and cost per Quality Adjusted Life Year (cost/QALY) was calculated. The cost-effectiveness analysis assessed the increase in service cost that would be necessary before the cost-effectiveness of the service was compromised. Results A total of 515 patients completed questionnaires at baseline. Of these, 486 were referred for face to face assessment with a physiotherapist and were included in the analysis for the current study. 264 (54.3%) and 199 (40.9%) were retained at end of treatment and 3 month follow up respectively. An improvement was observed at follow up in all the clinical outcomes assessed, as well as a reduction in healthcare resource usage and sickness absence, and improvement in self-reported work performance. Multivariate regression indicated that baseline and current physical health were associated with work-related outcomes at follow up. The costs of the service were £194-£360 per service user depending on the method used, and the health gains contributed to a cost/QALY of £1386-£7760, which would represent value for money according to current UK thresholds. Sensitivity analyses demonstrated that the service would remain cost effective until the service costs were increased to 160% per user. Conclusions: This pragmatic evaluation of the OHPPP indicated that it was likely to be feasible in terms of service usage and could potentially be cost effective in terms of QALYs. Further, the study confirmed that improving physical health status for musculoskeletal pain patients is important in reducing problems with work capacity and related costs. This study suggests that this type of service could be potentially be useful in reducing the burden of pain and should be further investigated, ideally via randomised controlled trials assessing effectiveness and cost-effectiveness