Healthcare Costs, Time to Fitness for Work, and Related Factors in Chronic Complex Regional Pain Syndrome: A Comparative and Longitudinal Study of 5-Year Follow-Up

Abstract

To assess and compare the healthcare costs, time to fitness for work (TFW) between chronic complex regional pain syndrome (CRPS) and non-CRPS; and identify factors associated with these outcomes in a comparative longitudinal study. Patients and Methods: 148 patients with chronic CRPS of the hand and 273 patients with chronic hand impairments but without CRPS (non-CRPS) were admitted at a Swiss rehabilitation clinic between 2007 and 2016. Healthcare costs and TFW were retrieved from insurance data over 5 years after the accident. Socio-demographic factors, biopsychosocial complexity measured by means of the INTERMED questionnaire, pain intensity and DASH disability scores were collected during rehabilitation. Generalized estimation equations and Cox proportional-hazards models were used to identify factors associated with outcomes. Results: Healthcare costs were increased by 20% for the CRPS versus non-CRPS group (coefficient = 1.20, 95% CI = 1.08-1.35, p<0.001). The median TFW was longer for CRPS than non-CRPS patients (816 vs 672 days, p = 0.02). After adjusting for covariates, TFW did not differ between the two groups (hazard ratio = 0.94, 95% CI = 0.73-1.21, p=0.61). For CRPS patients, higher healthcare costs were associated with severe or moderate initial injury, high INTERMED or DASH disability scores. Longer TFW were associated with severe initial injury, low educational level, no work contract, and high INTERMED or DASH disability scores. Conclusion: Overall, the healthcare costs were higher for CRPS than non-CRPS patients, but the TFW was comparable. We demonstrated also the significant associations of disability and biopsychosocial factors with the healthcare costs and TFW in CRPS patients.

Arthroscopic ankle surgery in people with haemophilia

“…Table 1 shows the current indications for arthroscopic ankle surgery in the general population. The complications of such surgery in the general population may be observed in Figure 1 22–34 . Figure 2 illustrates the rates of such complications over time, ranging from 7% to 14% between 2011 and 2021 24–28 …”

“…(A, B) Complications of arthroscopic surgery of the ankle in the general population (A); additional complications of arthroscopic surgery of the ankle in the general population (B) 22–34 …”

“…The complications of such surgery in the gen-TA B L E 1 Indications for ankle arthroscopy in the general population. [22][23][24][25][26][27][28][29][30][31][32][33][34] [22][23][24][25][26][27][28][29][30][31][32][33][34] F I G U R E 2 Complication rates of arthroscopic surgery of the ankle in the general population over the last 11 years (2011-2021). [24][25][26][27][28] eral population may be observed in Figure 1.…”

“…[24][25][26][27][28] eral population may be observed in Figure 1. [22][23][24][25][26][27][28][29][30][31][32][33][34] Figure 2 illustrates the rates of such complications over time, ranging from 7% to 14% between 2011 and 2021. [24][25][26][27][28] [35][36][37][38][39] (Table 2).…”

Economic evaluation of management strategies for complex regional pain syndrome (CRPS)

“…As the impact of CRPS on both patients and the global healthcare system continues to escalate, there is a growing inclination to comprehend the financial effects of its management approaches ( Elsamadicy et al, 2018 ; Duong et al, 2023 ). In a study (n = 35,316) by Elsamadicy et al the costs at the point of CRPS diagnosis, exhibited significant increases in comparison to baseline expenses: the overall costs stood at $8,508; outpatient expenses were $7,251; and pain prescription charges reached $2077.…”