The impact of specialised treatment of low back pain on health care costs and productivity in a nationwide cohort

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.

Download Full-text

PSY14 Health Care Costs and Opioid Use among Patients With Chronic Low Back Pain Initiating Duloxetine Versus Other Treatments

Value in Health ◽

10.1016/j.jval.2012.03.548 ◽

2012 ◽

Vol 15 (4) ◽

pp. A100-A101

Author(s):

J. Hong ◽

X. Peng ◽

J.S. Andrews ◽

D. Novick

Keyword(s):

Health Care ◽

Low Back Pain ◽

Back Pain ◽

Health Care Costs ◽

Chronic Low Back Pain ◽

Low Back ◽

Opioid Use ◽

Care Costs

Download Full-text

The association between depressive symptoms or depression and health outcomes in adults with low back pain with or without radiculopathy: protocol of a systematic review

Systematic Reviews ◽

10.1186/s13643-019-1192-4 ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Jessica J. Wong ◽

Andrea C. Tricco ◽

Pierre Côté ◽

Laura C. Rosella

Keyword(s):

Systematic Review ◽

Health Care ◽

Low Back Pain ◽

Back Pain ◽

Depressive Symptoms ◽

Health Outcomes ◽

Risk Of Bias ◽

Considerable Proportion ◽

Low Back ◽

The Impact

Abstract Background A considerable proportion of adults with low back pain (LBP) suffer from depressive symptoms or depression. Those with depressive symptoms or depression may be at risk of poorer LBP recovery and require more health care. Understanding the role of prognostic factors for LBP is critically important to guide management and health services delivery. Our objective is to conduct a systematic review to assess the association between depressive symptoms or depression and health outcomes in adults with LBP with or without radiculopathy. Methods Electronic databases including MEDLINE, Embase, CINAHL, and PsycINFO will be searched from inception to April 2019 to identify relevant studies. Additional citations will be identified by searching reference lists of included studies and related systematic reviews. Cohort and case-control studies assessing the association between depressive symptoms/depression and health outcomes in adults aged 16 years and older with LBP with or without radiculopathy will be included. The following will be included: depressive symptoms as measured on standardized questionnaires (e.g., Center for Epidemiologic Studies Depression Scale, Beck Depression Index), and depression as standardized diagnoses (e.g., International Classification of Diseases codes) or self-reported depression diagnosis on standardized questionnaires. Outcomes of interest are standardized measures for pain, disability, overall health status, satisfaction with care, and health care utilization. These are informed by core outcome domains that international expert panels consider important for LBP research. Pairs of reviewers will screen articles retrieved from the search, extract data, and assess risk of bias using the Risk Of Bias In Non-randomized Studies-of Exposures (ROBINS-E) tool. Reviewers will use these criteria to inform their judgment on the internal validity of studies (e.g., low, moderate, or high risk of bias). If studies are deemed homogeneous, a random effects meta-analysis on the association between depressive symptoms and health outcomes will be performed. The results of the included studies will be descriptively outlined if studies are deemed heterogeneous. Discussion The impact of depressive symptoms and depression on health- and health care-related outcomes for LBP with or without radiculopathy will be assessed and quantified. Findings of this systematic review will advance our understanding of LBP prognosis, and guide decision-making and improve quality of care for adults with LBP. Systematic review registration PROSPERO CRD42019130047

Download Full-text

Case Studies in Low Back Pain

Proceedings of the Human Factors Society Annual Meeting ◽

10.1177/154193128402800518 ◽

1984 ◽

Vol 28 (5) ◽

pp. 465-470

Author(s):

Tarek M. Khalil ◽

S.S. Asfour ◽

E.A. Moty

Keyword(s):

Health Care ◽

Low Back Pain ◽

Back Pain ◽

Rehabilitation Program ◽

Low Back ◽

Functional Abilities ◽

Rehabilitation Programs ◽

The Cost ◽

The Relationship ◽

Care Costs

This paper examines a number of cases involving injuries resulting in low back pain. Case history is given together with an Ergonomic evaluation profile. An aggressive low back rehabilitation program has been applied to all reported cases. The result of this rehabilitation effort related to improvement of functional abilities is given. The relationship to job environment is also discussed. The paper demonstrates the cost effectiveness considerations of low back pain rehabilitation programs with combined reference to worker's compensation laws, health care costs and productivity factors involved.

Download Full-text