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

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.