Informal caring for back pain: overlooked costs of back pain and projections to 2030 (original) (raw)
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The economic burden of back pain in the UK
Pain, 2000
This paper reports the results of a`cost-of-illness' study of the socio-economic costs of back pain in the UK. It estimates the direct health care cost of back pain in 1998 to be £1632 million. Approximately 35% of this cost relates to services provided in the private sector and thus is most likely paid for directly by patients and their families. With respect to the distribution of cost across different providers, 37% relates to care provided by physiotherapists and allied specialists, 31% is incurred in the hospital sector, 14% relates to primary care, 7% to medication, 6% to community care and 5% to radiology and imaging used for investigation purposes. However, the direct cost of back pain is insigni®cant compared to the cost of informal care and the production losses related to it, which total £10668 million. Overall, back pain is one of the most costly conditions for which an economic analysis has been carried out in the UK and this is in line with ®ndings in other countries. Further research is needed to establish the cost-effectiveness of alternative back pain treatments, so as to minimise cost and maximise the health bene®t from the resources used in this area. q 2000 International Association for the Study of Pain. Published by Elsevier Science B.V.
A cost-of-illness study of back pain in The Netherlands
Pain, 1995
In this study we estimated the costs of back pain to society in The Netherlands in 1991 to be 1.7% of the GNP. The results also show that musculoskeletal diseases are the fifth most expensive disease category regarding hospital care, and the most expensive regarding work absenteeism and disablement. One-third of the hospital care costs and one-half of the costs of absenteeism and disablement due to museuloskeletal disease were due to back pain. The total direct medical costs of back pain were estimated at US$367.6 million. The total costs of hospital care due to back pain constituted the largest part of the direct medical costs and were estimated at US$200 million. The mean costs of hospital care for back pain per case were US$3856 for an inpatient and US$199 for an outpatient. The total indirect costs of back pain for the entire labour force in The Netherlands in 1991 were estimated at US$4.6 billion; US$3.1 billion was due to absenteeism and US$1.5 billion to disablement. The mean costs per case of absenteeism and disablement due to back pain were US$4622 and US$9493, respectively. The indirect costs constituted 93% of the total costs of back pain, the direct medical costs contributed only 7%. It is therefore concluded that back pain is not only a major medical problem but also a major economical problem.
The economic burden of low back pain: a review of studies published between 1996 and 2001
Best Practice & Research Clinical Rheumatology, 2002
Low back pain (LBP) poses an economic burden to society, mainly in terms of the large number of work days lost by a small percentage of patients who develop chronic LBP. The object of this review is to gain a better understanding of the societal costs of LBP and to see whether current clinical management follows evidence-based guidelines and is economically attractive, by reviewing studies on LBP with economic implications. To this end, the Medline database was searched between 1996 and 2001 using appropriate keywords, broadly de®ned. A total of 372 abstracts were screened and paper copies of 73 potentially relevant articles were obtained.
Journal of Manipulative and Physiological Therapeutics, 2011
Objectives-The purpose of this study was to explore the extent to which individuals with back pain or other health conditions, and individuals with no health problems, report having a usual source of care (USC) for their health care needs. Methods-This study evaluated longitudinal Medical Expenditures Panel Survey data (MEPS data pooled for survey calendar years 2000-through-2006). Comparisons were made between adult MEPS respondents identified as having a back pain condition (n=10,194) compared to those without back pain but with other health condition (n=45,541), and those with no back pain and no other condition (n=5,497). Results-Compared to individuals with no health problems, those with back pain were almost 8 times more likely (OR=7.8, p<.001) to report having a USC; and those with other health problems besides back pain were 5 times more likely (OR=5.4, p<.001). For those with a USC, individuals with back pain, and those with other problems but not back pain, were both about one and a half times more likely than those without any health problems to report a specific provider type as their USC (p<.001). Conclusion-Study findings suggest that relatively healthy adults without back pain are less likely to have a USC than those with back pain or other health problems.
Economic Burden of Low Back Pain on Patients Seen
Journal of Nigeria Society of Physiotherapy, 2011
A limited amount of data exists on the burden of low back pain (LBP) in developing countries. This study was therefore carried out to determine the economic burden of LBP on patients seen in out-patient physiotherapy clinics of secondary and tertiary health institutions in Ibadan. Forty (25 males, 15 females) individuals with LBP receiving physiotherapy in secondary and tertiary health institutions in Ibadan participated in this crosssectional study. Data on the economic burden of LBP and socio-demographic information of participants were collected using a self-developed questionnaire. Participants' disability was assessed using the Rolland Morris Low Back Pain Disability Questionnaire. Data was analysed using descriptive statistics of proportions, mean and standard deviations, inferential statistics of Chi-square and an independent t-test. Level of significance was set at 0.05. The overall estimated annual economic costs (direct cost -114,666.25±74230.53 naira; indirect cost 24,495.00±16,837.13 naira) of LBP were averaged at 139,156.25±77091.16 naira. The average loss of work hours per hospital visit was estimated at 10.25± 6.75 hours per month. There was no significant difference between the economic costs of male and female patients with LBP (p=0.598). There was a significant association (p=0.04) between economic cost of care and disability. It was concluded that the direct cost of care accounted for majority of the money spent by patients with LBP receiving physiotherapy . Cost of care in LBP increases with disability.
Background Back pain is a common and costly health problem worldwide. There is yet a lack of consistent methodologies to estimate the economic burden of back pain to society. Objective To systematically evaluate the methodologies used in the published cost of illness (COI) literature for estimating the direct and indirect costs attributed to back pain, and to present a summary of the estimated cost burden. Methods Six electronic databases were searched to identify COI studies of back pain published in English up to February 2021. A total of 1,588 abstracts were screened, and 55 full-text studies were subsequently reviewed. After applying the inclusion criteria, 45 studies pertaining to the direct and indirect costs of back pain were analysed.
PLoS ONE, 2013
Background: Back pain impacts on a significant proportion of the Australian population over the life course and has high prevalence rates among women, particularly in older age. Back pain care is characterised by multiple practitioner and selfprescribed treatment options, and the out-of-pocket costs associated with consultations and self-prescribed treatments have not been examined to date. Objective: To analyse the extent of health care practitioner consultations and self-prescribed treatment for back pain care among Australian women, and to assess the self-reported costs associated with such usage. Methods: Survey of 1,310 women (response rate 80.9%) who reported seeking help for back pain from the '1946-51 cohort' of the Australian Longitudinal Study on Women's Health. Women were asked about their use of health care practitioners and self-prescribed treatments for back pain and the costs associated with such usage. Results: In the past year 76.4% consulted a complementary and alternative practitioner, 56% an allied health practitioner and 59.2% a GP/medical specialist. Overall, women consulted with, on average, 3.0 (SD = 2.0) different health care practitioners, and had, on average, 12.2 (SD = 9.7) discrete health care practitioner consultations for back pain. Average selfreported out-of-pocket expenditure on practitioners and self-prescribed treatments for back pain care per annum was AU$873.10. Conclusions: Multiple provider usage for various but distinct purposes (i.e. pain/mobility versus anxiety/stress) points to the need for further research into patient motivations and experiences of back pain care in order to improve and enhance access to and continuity of care. Our results suggest that the cost of back pain care represents a significant burden, and may ultimately limit women's access to multiple providers. We extrapolate that for Australian working-age women, total out-ofpocket expenditure on back pain care per annum is in excess of AU$1.4billion, thus indicating the prominence of back pain as a major economic, social and health burden.