Healthcare utilization of back pain patients: results of a claims data analysis

Abstract

The results show the potential that could be made accessible by an early detection of back pain patients who bear a risk of pain becoming chronic, both in terms of quality-of-life as well as in financial terms.

The societal burden of pain in Germany: Health-related quality-of-life, health status and direct medical costs

“…More specifically, Frettlöh et al 5 assessed the prevalence and correlates of chronic pain in German pain centers, while Friessem et al 6 provided estimates of the prevalence of chronic pain in primary care. More recently, Müller-Schwefe et al 7 utilized statutory health insurance fund claim data to assess the impact of back pain on healthcare resource utilization and costs. Predictors of chronic widespread pain and fibromyalgia were considered by Häuser et al 8 , while Beesdo et al 9 , again in a national sample, considered the association of pain with anxiety and depressive disorders.…”

The chronic pain conundrum: should we CHANGE from relying on past history to assessing prognostic factors?

“…The Factbook of Pain research project in Germany, a collaboration between the IGES Institute, Grünenthal GmbH and the DAK-Unternehmen Leben insurance company, has identified a number of ways in which both costs and unmet needs might be reduced by adopting an integrated approach 38 . For example, very few patients with chronic back pain (54%) receive a specific pain therapy.…”

“…Around one-third of patients with specific back pain and three-fifths of patients with non-specific back pain are prescribed no analgesics at all. Even when the development of chronic pain is strongly indicated, less than one-fifth of patients with back pain receive in-patient multimodal pain therapy 38 . This is despite the fact that the presence of indicators for chronic pain vastly increases the number of work disability days, and effective treatment is beneficial not only for the individual but also economically; patients with some types of back pain average more than 25 work disability days each year, and back pain is by far the most common type of chronic pain, so the potential financial savings are enormous 38 .…”

Health Care Costs attributable to Hospital-diagnosed Back Pain: A Longitudinal Register-based Study of the Danish Population

“…The identification strategy was based on a previously published algorithm that has been developed to identify pain patients from administrative data that include diagnostic codes of the International Disease Classification version 10. 8,11 The algorithm provides a classification into three diagnostic subgroups: pain in spinal disc disorders (M50 cervical disc disorders and M51 other intervertebral disc disorders), (other) specific back pain (M43 other deforming dorsopathies; M45 ankylosing spondylitis; M46 other inflammatory spondylopathies; M48 other spondylopathies; M49 spondylopathies in diseases classified elsewhere; M81 osteoporosis without pathological fracture and M82 osteoporosis in diseases classified elsewhere) and non-specific back pain (M47 spondylosis; M53 other dorsopathies, not elsewhere classified and M54 dorsalgia). Individuals who were not listed with any of these diagnoses were classified as not having hospital-diagnosed back pain.…”

“…6,7 It is also well known that different diagnostic groups (often contrasted by specific and non-specific back pain) have different prognoses for symptom relief and therefore can be expected to demonstrate different cost rates. 8 Another caveat is that it is extremely complex to disentangle back pain costs from comorbidity costs that seem to constitute a major part of the total costs. 9 Altogether, these facts suggest that reference values for health care use across individuals with back pain should distinguish between age-and gender strata as well as diagnostic subgroups, and that the analytical approach should be designed to include comorbidity, if it can be attributed to back pain.…”