Geurts José W, Willems Paul C, Kallewaard Jan-Willem, van Kleef Maarten, Dirksen Carmen
Department of Anesthesiology and Pain Medicine, Maastricht University Medical Centre, Maastricht, Netherlands.
Department of Anesthesiology and Pain Management, Rijnstate Hospital, Arnhem, Netherlands.
Pain Res Manag. 2018 Oct 1;2018:4696180. doi: 10.1155/2018/4696180. eCollection 2018.
Chronic discogenic low back pain (CDP) is frequently diagnosed in patients referred to specialized pain clinics for their back pain. The aim of this study is to assess the impact of CDP both on the individual patient and on society.
Using the baseline records of 80 patients in a randomized trial assessing the effectiveness of a new intervention for CDP, healthcare and societal costs related to back pain are calculated. Furthermore, the impact of the condition on perceived pain, disability, health-related quality of life, Quality of life Adjusted Life Years (QALY), and QALY loss is assessed.
Using the friction costs approach, we found that the annual costs for society are €7,911.95 per CDP patient, 51% healthcare and 49% societal costs. When using the human capital approach, total costs were €18,940.58, 22% healthcare and 78% societal costs. Healthcare costs were mainly related to pain treatment. Mean pain severity was 6.5 (0-10), and 46% suffered from severe pain (≥7/10). Mean physical limitations rate was 43.7; 13.5% of the patients were very limited to disabled. QALY loss compared to a healthy population was 64%.
This study shows that in patients with CDP referred to a pain clinic, costs for society are high and the most used healthcare resources are pain therapies. Patients suffer severe pain, are physically limited, and experience a serious loss in quality of life.
慢性椎间盘源性下腰痛（CDP）在因背痛前往专科疼痛诊所就诊的患者中经常被诊断出来。本研究的目的是评估CDP对个体患者和社会的影响。
利用一项评估CDP新干预措施有效性的随机试验中80名患者的基线记录，计算与背痛相关的医疗保健和社会成本。此外，评估该疾病对感知疼痛、残疾、健康相关生活质量、质量调整生命年（QALY）和QALY损失的影响。
采用摩擦成本法，我们发现每位CDP患者每年的社会成本为7911.95欧元，其中51%为医疗保健成本，49%为社会成本。采用人力资本法时，总成本为18940.58欧元，其中22%为医疗保健成本，78%为社会成本。医疗保健成本主要与疼痛治疗有关。平均疼痛严重程度为6.5（0 - 10），46%的患者遭受严重疼痛（≥7/10）。平均身体限制率为43.7；13.5%的患者非常受限至残疾。与健康人群相比，QALY损失为64%。
本研究表明，在转诊至疼痛诊所的CDP患者中，社会成本很高，最常用的医疗保健资源是疼痛治疗。患者遭受严重疼痛，身体受限，生活质量严重下降。
