Economic evaluation of peer support for second victims: Investing in healthcare workforce well-being

Abstract Healthcare professionals are frequently exposed to emotionally challenging events, contributing to a significant and growing mental health burden within the workforce. The Second Victim Phenomenon (SVP) refers to the emotional distress healthcare professionals may suffer after being involved in unexpected adverse events, errors, or patient injuries - affecting nearly 60% of physicians and nurses in Germany. This study evaluates whether national investment in peer support structures offers a cost-effective solution to promote workforce health and sustainability. The study used data from the SeViD-I and II surveys to estimate the economic burden of the SVP among German hospital staff, focusing on costs from absenteeism and turnover. A health economic model projected potential savings from nationwide peer-support programs, supported by sensitivity analyses to account for varying symptom durations and recovery outcomes. The economic analysis estimates annual SVP-related absenteeism costs of €1.56 billion for physicians and €1.87 billion for nurses. A nationwide rollout of structured psychosocial peer-support could reduce these costs to €0.85 billion and €1.02 billion, respectively-yielding potential annual savings exceeding €1.55 billion. Sensitivity analyses affirm the robustness of these projections. Beyond cost savings, peer-support programs contribute to health equity by providing accessible, stigma-free mental health resources, improving resilience, reducing turnover and sick days, and supporting patient safety. The findings underscore the importance of institutionalizing peer support as a public health strategy that not only improves workforce mental well-being but also enhances system efficiency and the overall quality of care. Key messages • The Second Victim Phenomenon leads to an estimated annual cost of €3.43 billion due to absenteeism among physicians and nurses in Germany's hospital sector. • Nationwide implementation of peer support programs could reduce these costs by over €1.55 billion annually - demonstrating a clear economic incentive for investing in structured psychosocial support.