Psychiatric comorbidity as predictor of costs in back pain patients undergoing disc surgery: a longitudinal observational studyReport as inadecuate




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BMC Musculoskeletal Disorders

, 13:165

First Online: 03 September 2012Received: 12 September 2011Accepted: 21 August 2012

Abstract

BackgroundPsychiatric comorbidity is common in back pain patients undergoing disc surgery and increases economic costs in many areas of health. The objective of this study was to analyse psychiatric comorbidity as predictor of direct and indirect costs in back pain patients undergoing disc surgery in a longitudinal study design.

MethodsA sample of 531 back pain patients was interviewed after an initial disc surgery T0, 3 months T1 and 15 months T2 using the Composite International Diagnostic Interview to assess psychiatric comorbidity and a modified version of the Client Sociodemographic and Service Receipt Inventory to assess resource utilization and lost productivity for a 3-month period prior interview. Health care utilization was monetarily valued by unit costs and productivity by labour costs. Costs were analysed using random coefficient models and bootstrap techniques.

ResultsPsychiatric comorbidity was associated with significantly p < 0.05 increased direct +664 Euro and indirect costs +808 Euro at T0. The direct cost difference predominantly resulted from medical health care utilization and was nearly unchanged at T2. Further important cost predictors were clinical variables like the presence of chronic medical disease, the number of previous disc surgeries, and time and gender.

ConclusionPsychiatric comorbidity presents an important predictor of direct and indirect costs in back pain patients undergoing disc surgery, even if patients do not utilize mental health care. This effect seems to be stable over time. More attention should be given to psychiatric comorbidity and cost-effective treatments should be applied to treat psychiatric comorbidity in back pain patients undergoing disc surgery to reduce health care utilization and costs associated with psychiatric comorbidity.

KeywordsBack pain Disc surgery Psychiatric comorbidity Cost Economic  Download fulltext PDF



Author: Alexander Konnopka - Margrit Löbner - Melanie Luppa - Dirk Heider - Sven Heinrich - Steffi Riedel-Heller - Hans Jörg Mei

Source: https://link.springer.com/







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