Avoidable costs of physical treatments for chronic back, neck and shoulder pain within the Spanish National Health Service: a cross-sectional study

BMC Musculoskeletal Disorders

Lidia García-Pérez⁴  Juan M Ramos-Goñi⁴  Jose M Cabrera-Hernández²  Francisco M Kovacs¹  Pedro Serrano-Aguilar³ 

[1] Spanish Back Pain Research Network (REIDE), Palma de Mallorca, Spain;General Directorate of Health Care Programmes. Canary Islands Health Service. Government of the Canary Islands, Santa Cruz de Tenerife, Spain;Servicio de Evaluación, Dirección del Servicio Canario de la Salud, Pérez de Rozas 5, 4th floor, 38004 Santa Cruz de Tenerife, Canary Islands, Spain;Fundación Canaria de Investigación y Salud (FUNCIS), Santa Cruz de Tenerife, Spain

关键词: Shoulder pain;    Neck pain;    Back pain;    Avoidable costs;    Evidence based practice;    Treatment costs;    Physical therapy;   

Others  :  1150944
DOI  :  10.1186/1471-2474-12-287

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

【 摘 要 】

Background

Back, neck and shoulder pain are the most common causes of occupational disability. They reduce health-related quality of life and have a significant economic impact. Many different forms of physical treatment are routinely used. The objective of this study was to estimate the cost of physical treatments which, despite the absence of evidence supporting their effectiveness, were used between 2004 and 2007 for chronic and non-specific neck pain (NP), back pain (BP) and shoulder pain (SP), within the Spanish National Health Service in the Canary Islands (SNHSCI).

Methods

Chronic patients referred from the SNHSCI to private physical therapy centres for NP, BP or SP, between 2004 and 2007, were identified. The cost of providing physical therapies to these patients was estimated. Systematic reviews (SRs) and clinical practice guidelines (CPGs) for NP, BP and SP available in the same period were searched for and rated according to the Oxman and AGREE criteria, respectively. Those rated positively for ≥70% of the criteria, were used to categorise physical therapies as Effective; Ineffective; Inconclusive; and Insufficiently Assessed. The main outcome was the cost of physical therapies included in each of these categories.

Results

8,308 chronic cases of NP, 4,693 of BP and 5,035 of SP, were included in this study. Among prescribed treatments, 39.88% were considered Effective (physical exercise and manual therapy with mobilization); 23.06% Ineffective; 13.38% Inconclusive, and 23.66% Insufficiently Assessed. The total cost of treatments was € 5,107,720. Effective therapies accounted for € 2,069,932.

Conclusions

Sixty percent of the resources allocated by the SNHSCI to fund physical treatment for NP, BP and SP in private practices are spent on forms of treatment proven to be ineffective, or for which there is no evidence of effectiveness.

【 授权许可】

   
2011 Serrano-Aguilar et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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