Ekman Mattias, Jönhagen Sven, Hunsche Elke, Jönsson Linus
Stockholm Health Economics, Stockholm, Sweden.
Spine (Phila Pa 1976). 2005 Aug 1;30(15):1777-85. doi: 10.1097/01.brs.0000171911.99348.90.
Cross-sectional survey of patients with chronic low back pain in primary care setting.
To analyze the health care resource use, productivity loss, and health-related quality of life of patients with chronic low back pain in Sweden.
Despite the clinical and economic importance of chronic LBP, the overall burden of the disease is not well documented.
Cross-sectional data on patients' socio-demographics, disease-related healthcare resource use during the past 6 months, inability to work during the previous 3 months, and quality of life at the time of the study visit were collected using questionnaires completed during an outpatient visit. Patient recruitment and data collection was performed at 14 primary care centers in Sweden. Patients over 18 years of age with chronic LBP present at least 50% of the days during the previous 3 months were included. Regression analysis was used to investigate factors associated with variation in costs.
Based on a sample of 302 patients, the total annual direct costs for chronic LBP per patient were estimated at 3,100 Euros, or 2,900 United States dollars, in 2002 prices, constituting 15% of the total annual LBP costs per patient. The indirect costs (mainly productivity loss because of lost work days) were estimated at 17,600 Euros (16,600 United States dollars) per patient, or 85% of the total LBP costs per patient. Direct and indirect costs were positively correlated with disease severity, disease duration, and female gender. The mean Roland & Morris score was 12.2, and the Medical Outcomes Study 8-Item Short Form physical and mental summary component scores were 35.2 and 41.6, respectively.
In Sweden, the indirect costs for chronic LBP appear to be substantially higher than the direct costs for pharmaceuticals, medical visits, physiotherapy, andhospitalizations. The high indirect costs indicate that more effective treatments for chronic LBP could potentially lead to cost savings even if the therapy costs were higher.
对基层医疗环境中慢性下腰痛患者进行横断面调查。
分析瑞典慢性下腰痛患者的医疗资源使用情况、生产力损失以及与健康相关的生活质量。
尽管慢性下腰痛在临床和经济方面都很重要，但该疾病的总体负担尚无充分记录。
通过门诊就诊时填写的问卷收集患者的社会人口统计学数据、过去6个月与疾病相关的医疗资源使用情况、前3个月无法工作的情况以及研究就诊时的生活质量。在瑞典的14个基层医疗中心进行患者招募和数据收集。纳入年龄超过18岁、在前3个月中至少50%的天数患有慢性下腰痛的患者。采用回归分析来研究与成本变化相关的因素。
基于302名患者的样本，按2002年价格估算，每位慢性下腰痛患者每年的直接成本为3100欧元，即2900美元，占每位患者每年下腰痛总成本的15%。间接成本（主要是因误工天数导致的生产力损失）估计为每位患者17600欧元（16600美元），占每位患者下腰痛总成本的85%。直接和间接成本与疾病严重程度、病程和女性性别呈正相关。罗兰·莫里斯评分的平均值为12.2，医学结局研究8项简短形式身体和心理总结成分得分分别为35.2和41.6。
在瑞典，慢性下腰痛的间接成本似乎远高于药物、就诊、物理治疗和住院的直接成本。高昂的间接成本表明，即使治疗成本更高，对慢性下腰痛更有效的治疗方法可能会带来成本节约。
