Direct Health Care Cost and Work Incapacity Related to Complex Regional Pain Syndrome in Switzerland: A Retrospective Analysis from 2008 to 2015

Abstract

Objective First, to determine the number of accident-related complex regional pain syndrome (CRPS) cases from 2008 to 2015 and to identify factors associated with an increased risk for developing CRPS. Second, to analyze the duration of work incapacity and direct health care costs over follow-up periods of two and five years, respectively. Design Retrospective data analysis. Setting Database from the Statistical Service for the Swiss National Accident Insurances covering all accidents insured under the compulsory Swiss Accident Insurance Law. Subjects Subjects were registered after an accident between 2008 and 2015. Methods Cases were retrospectively retrieved from the Statistical Service for the Swiss National Accident Insurances. Cases were identified using the appropriate International Classification of Diseases, 10th Revision, codes. Results CRPS accounted for 0.15% of all accident cases. Age, female gender (odds ratio [OR] = 1.53, 95% confidence interval [CI] = 1.47–1.60), and fracture of the forearm (OR = 38, 95% CI = 35–42) were related to an increased risk of developing CRPS. Over five years, one CRPS case accumulated average insurance costs of $86,900 USD and treatment costs of $23,300 USD. Insurance costs were 19 times and treatment costs 13 times the average costs of accidents without CPRS. Within the first two years after the accident, the number of days lost at work was 20 times higher in patients with CRPS (330 ± 7 days) than in patients without CRPS (16.1 ± 0.1 days). Two-thirds of all CRPS cases developed long-term work incapacity of more than 90 days. Conclusion CRPS is a relatively rare condition but is associated with high direct health care costs and work incapacity.

Complex regional pain syndrome: An international survey of clinical practice

“…This survey provides support for health care resources to be directed towards the early diagnosis and intervention of CRPS. This is further supported by a recent retrospective analysis conducted in a Swiss post‐accident population, which reported that average treatment costs, after an accident resulting in CRPS, were 13 times higher, and the number of days lost at work were 20 times higher, than those in patients without CPRS (Scholz‐Odermatt et al, ).…”

“…Health care systems have many competing demands. Despite being a relatively rare condition, CRPS is associated with significant economic consequences (Kemler, Raphael, Bentley, & Taylor, ; Scholz‐Odermatt, Luthi, Wertli, & Brunner, ). This survey provides support for health care resources to be directed towards the early diagnosis and intervention of CRPS.…”

The Role of Nonmedical Therapeutic Approaches in the Rehabilitation of Complex Regional Pain Syndrome

“…Although many cases will resolve within 6 to 13 months, a recent systematic review found that between 22 and 64% of patients experience persistent symptoms ≥3 years after diagnosis [20] and, as a consequence, CRPS has a significant impact on the health economy and health-related quality of life [21]. A recent retrospective analysis of the Swiss National Accident Insurance database reported high economic costs associated with CRPS [22]. Average treatment costs were found to be 13 times greater, and the number of working days lost was 20 times higher, in patients with CRPS after an accident, compared with those without CRPS [22].…”

Treatment of Distal Radius Fracture: Does Early Activity Postinjury Lead to a Lower Incidence of Complex Regional Pain Syndrome?

“…3 Because the optimal treatment for a DRF remains an ongoing discussion and the duration of immobilization is still a subject of debate, this study observed whether early activity postinjury can lead to prevention of type 1 complex regional pain syndrome (CRPS-1), [4][5][6][7] a syndrome that can lead to high health care costs and inability to work. 8 Type 1 complex regional pain syndrome is described as a posttraumatic pain syndrome combined with an autonomic disorder and includes excessive pain, edema, changes in skin blood flow, abnormal sudomotor activity, sensory and motor disturbances and severe disability leading to mood changes, loss of work capacity, and decreased participation in recreational activities. 9,10 The diagnosis is based on a combination of symptoms reported by the patients and signs observed during physical examination by the physician.…”