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

BMC Musculoskeletal Disorders

Hans-Helmut König²  Jürgen Meixensberger⁵  Lutz Günther¹  Hans Jörg Meisel³  Steffi Riedel-Heller⁴  Sven Heinrich²  Dirk Heider⁴  Melanie Luppa⁴  Margrit Löbner⁴  Alexander Konnopka² 

[1] Department of Neurosurgery, Hospital St. Georg gGmbH, Leipzig, Germany;Department of Medical Sociology and Health Economics, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany;Department of Neurosurgery, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle (Saale), Germany;Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany;Department of Neurosurgery, University of Leipzig, Leipzig, Germany

关键词: Economic;    Cost;    Psychiatric comorbidity;    Disc surgery;    Back pain;   

Others  :  1145904
DOI  :  10.1186/1471-2474-13-165

 received in 2011-09-12, accepted in 2012-08-21,  发布年份 2012

【 摘 要 】

Background

Psychiatric 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.

Methods

A 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.

Results

Psychiatric 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.

Conclusion

Psychiatric 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.

【 授权许可】

   
2012 Konnopka et al.; licensee BioMed Central Ltd.

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