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初级保健中背痛所致的医疗资源利用和经济负担:英国一项配对病例对照研究。

Healthcare resource utilisation and economic burden attributable to back pain in primary care: A matched case-control study in the United Kingdom.

作者信息

Zemedikun Dawit T, Kigozi Jesse, Wynne-Jones Gwenllian, Guariglia Alessandra, Nirantharakumar Krishnarajah, Marshall Tom, Roberts Tracy

机构信息

Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

出版信息

Br J Pain. 2024 Apr;18(2):137-147. doi: 10.1177/20494637231208364. Epub 2023 Oct 20.

Abstract

OBJECTIVE

Incremental healthcare costs attributed to back pain, and characterisation by patient and clinical factors have rarely been documented. This study aimed to assess annual healthcare resource utilisation and costs associated with back pain in primary care.

METHODS

Using the IQVIA Medical Research Data (IMRD), patients with back pain were identified (study period: 01 January 2006 to 31 December 2015) using diagnostic records and analgesics prescriptions ( = 133,341), and propensity score matched 1:1 to patients without back pain. The annual incremental costs of back pain associated with consultations and prescriptions were estimated and extrapolated to a national level. Sensitivity analysis was conducted by restricting the study population to the most recent diagnosis of back pain. Variations in cost were assessed stratified by gender, age-groups, deprivation, and comorbidity categories.

RESULTS

The mean age was 57 years, and 62% were females in both the case and control groups. The total incremental healthcare costs associated with back pain was £32.5 million in 2015 (£35.9 million in 2020), with per-patient cost of £244 (£265 in 2020) per year. On a national level, this translated to an estimated £3.2 billion (£3.5 billion in 2020). Eighty percent of the costs were attributed to consultations; and female gender, older age, higher deprivation, and higher comorbidity were all associated with increased mean healthcare costs of patients with back pain.

CONCLUSION

Our findings confirm the substantial healthcare costs attributed to back pain, even with primacy care costs only. The data also revealed significant cost variations across socio-demographic and clinical factors.

摘要

目的

归因于背痛的医疗保健成本增加以及按患者和临床因素进行的特征描述鲜有文献记载。本研究旨在评估初级保健中与背痛相关的年度医疗资源利用情况和成本。

方法

利用艾昆纬医学研究数据(IMRD),通过诊断记录和镇痛药处方识别出背痛患者(研究期间:2006年1月1日至2015年12月31日)(n = 133,341),并按倾向得分1:1与无背痛患者进行匹配。估计与会诊和处方相关的背痛年度增量成本,并推算至全国水平。通过将研究人群限制为最近诊断出的背痛患者进行敏感性分析。按性别、年龄组、贫困程度和合并症类别对成本差异进行分层评估。

结果

病例组和对照组的平均年龄均为57岁,女性均占62%。2015年与背痛相关的医疗保健总增量成本为3250万英镑(2020年为3590万英镑),每位患者每年的成本为244英镑(2020年为265英镑)。在全国范围内,这相当于估计32亿英镑(2020年为35亿英镑)。80%的成本归因于会诊;女性、年龄较大、贫困程度较高和合并症较多均与背痛患者的平均医疗保健成本增加相关。

结论

我们的研究结果证实,即使仅考虑初级保健成本,背痛也会带来巨大的医疗保健成本。数据还显示,社会人口统计学和临床因素存在显著的成本差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92f0/10964861/1db8deb4be92/10.1177_20494637231208364-fig1.jpg

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