School of Physical Therapy, Master in Rehabilitation Sciences, Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil.
Núcleo de Evidências e Tecnologias em Saúde (NETecS), Universidade de Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil.
PLoS One. 2020 Apr 1;15(4):e0230902. doi: 10.1371/journal.pone.0230902. eCollection 2020.
Low Back Pain (LBP) is associated with an increase in disability-adjusted life years, and increased risk of disability retirement and greater absenteeism in Brazil. Hence, evidence on healthcare and lost productivity costs due to LBP is of utmost importance to inform decision-makers.
Cost-of-illness study with top-down approach, and societal perspective. We extracted data from National databases, considering the period 2012-2016. Outpatient expenses included clinical, surgical, diagnosis, orthosis/prosthetics, and complementary actions. Inpatient care expenses included hospital and professional services, intensive care unit, and companion stay. For productivity losses, duration of work absence and associated information (work-related and non-work-related; value of the sickness absence benefit; age; gender; and economic activity) were analyzed. Lost productivity costs were calculated multiplying the absence from work (days) by the daily-benefit.
The societal costs amounted to US$ 2.2 billion, and productivity losses represented 79% of the costs. Total healthcare expenses were estimated to US$ 460 million. We found more than 880,000 diagnostic images. Individuals with LBP were in total 59 million days absent from work between 2012-2016. The mean lost days absent from work per person, for each year investigated was, respectively, 88; 84; 83; 87; and 100. Men were more days absent from work than women. In addition, rural workers presented greater absence from work compared to other professional activities.
Healthcare expenses and lost productivity costs due to LBP were substantial, hence, there is a need for improvement of health services and policies to deal with this increasing burden of illness. We found an extensive use of diagnostic imaging, which is rather discouraged by clinical guidelines. We assume that men were experiencing high levels of back pain disability compared with women, as they presented greater absenteeism and higher lost productivity costs.
下背痛（LBP）与残疾调整生命年的增加有关，并增加了巴西残疾退休和旷工的风险。因此，有关 LBP 的医疗保健和生产力损失成本的证据对于决策者至关重要。
采用自上而下的方法和社会视角进行疾病负担研究。我们从国家数据库中提取数据，时间范围为 2012-2016 年。门诊费用包括临床、手术、诊断、矫形器/假肢和补充治疗。住院治疗费用包括医院和专业服务、重症监护病房和陪护住宿。对于生产力损失，分析了工作缺勤时间和相关信息（与工作相关和非工作相关；病假津贴价值；年龄；性别；和经济活动）。通过将缺勤天数（天）乘以每日津贴来计算丧失的生产力成本。
社会成本为 22 亿美元，生产力损失占成本的 79%。总医疗费用估计为 4.6 亿美元。我们发现了超过 88 万张诊断图像。2012-2016 年期间，患有 LBP 的个体总共有 5900 多万天缺勤。每年调查的人均平均缺勤天数分别为 88；84；83；87；和 100。男性的缺勤天数多于女性。此外，与其他职业活动相比，农村劳动者缺勤时间更长。
LBP 导致的医疗保健费用和生产力损失成本相当可观，因此需要改善卫生服务和政策以应对这种日益增加的疾病负担。我们发现诊断成像的广泛使用，这与临床指南相矛盾。我们假设男性比女性经历更高水平的腰痛残疾，因为他们的缺勤时间更长，生产力损失成本更高。
