scholarly journals Characteristics and health care costs in patients with a diagnostic imaging for low back pain in Switzerland

Author(s):  
Stefania Di Gangi ◽  
Christophe Bagnoud ◽  
Giuseppe Pichierri ◽  
Thomas Rosemann ◽  
Andreas Plate

AbstractLow back pain (LBP) is one of the most common musculoskeletal disorders worldwide and a frequent cause for health care utilization with a high economic burden. A large proportion of diagnostic imaging in patients with LBP is inappropriate and can cause more harm than good, which in turn can lead to higher health care costs. The aim of this study was to determine characteristics and health care costs for patients with a diagnostic imaging for LBP in Switzerland. Groupe Mutuel, one of the biggest health care insurance companies in Switzerland and covering approximately 12% of the population, provided data for this analysis. Patients were identified by diagnostic imaging for the lumbar spine in 2016 or 2017. The study period was 2015–2019, that is one year before and two years after the year of imaging. Regression analysis models were used to identify patient variables associated with higher health care costs. A total of 75,296 patients (57% female, mean age: 54.5 years) were included into the study. Magnetic resonance imaging was the most commonly used diagnostic method (44.3%). Patients generated annual mean health care costs of 518,488,470 CHF (466,639,621 Euro) in the whole observation period; 640 million CHF (576 million Euro) in the index year. Overall, costs for LBP patients were 72% higher compared with the costs of no LBP patients. Our findings confirm the economic burden of LBP and highlight the importance of ongoing efforts to improve prevention, diagnostics and patient care in patients with LBP.

Spine ◽  
2005 ◽  
Vol 30 (9) ◽  
pp. 1075-1081 ◽  
Author(s):  
Molly T. Vogt ◽  
C Kent Kwoh ◽  
Doris K. Cope ◽  
Thaddeus A. Osial ◽  
Michael Culyba ◽  
...  

2022 ◽  
Vol 43 ◽  
pp. 101247
Author(s):  
Stian Solumsmoen ◽  
Gry Poulsen ◽  
Jakob Kjellberg ◽  
Mads Melbye ◽  
Tina Nørgaard Munch

2021 ◽  
Author(s):  
Kenneth Harwood ◽  
Jesse Pines ◽  
C. Holly A. Andrilla ◽  
Bianca K. Frogner

Abstract Background: Diagnostic testing and treatment recommendations can vary when medical care is sought by individuals for low back pain (LBP), leading to variation in quality and costs of care. We examine how first provider seen by an individual at initial diagnosis of LBP influences downstream utilization and costs. Methods: Using national private health insurance claims data, individuals age 18 or older were retrospectively assigned to cohorts based on the first provider seen at the index date of LBP diagnosis. Exclusion criteria included individuals with a diagnosis of LBP or any serious medical conditions, or an opioid prescription recorded in the six months prior to the index date. Outcome measures included use of imaging, back surgery rates, hospitalization rates, emergency department visits, early- and long-term opioid use, and costs (out-of-pocket and total costs of care) twelve months post-index date. We used a common econometric technique, two-stage residual inclusion (2SRI) estimation to reduce selection bias in the choice of first provider, controlling for demographics.Results: Among 3,799,593 individuals, cost and utilization varied considerably based on first provider seen by the patient. The frequency of early opioid prescription was significantly lower when care began with an acupuncturist or chiropractor, and highest for those who began with an emergency medicine physician or advanced practice registered nurse (APRN). Long-term opioid prescriptions were low across most providers except physical medicine and rehabilitation physicians and APRNs. The frequency and time to serious illness varied little across providers. Total cost of care was lowest when starting with a chiropractor ($5,093) or primary care physician ($5,660), and highest when starting with an orthopedist ($9,434) or acupuncturist ($9,205). Conclusion: The first provider seen by individuals with LBP was associated with large differences in health care utilization, opioid prescriptions, and cost while there were no differences in delays in diagnosis of serious illness.


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