Abstract
BackgroundPainful shoulders pose a substantial socioeconomic burden. A prospective cost-of-illness study was performed to assess the costs associated with healthcare use and loss of productivity in patients with shoulder pain in primary health care in Sweden.MethodsThe study was performed in western Sweden, in a region with 24 000 inhabitants. Data were collected during six months from electronic patient records at three primary healthcare centres in two municipalities. All patients between 20 and 64 years of age who presented with shoulder pain to a general practitioner or a physiotherapist were included. Diagnostic codes were used for selection, and the cases were manually controlled. The cost for sick leave was calculated according to the human capital approach. Sensitivity analysis was used to explore uncertainty in various factors used in the model.Results204 (103 women) patients, mean age 48 (SD 11) years, were registered. Half of the cases were closed within six weeks, whereas 32 patients (16%) remained in the system for more than six months. A fifth of the patients were responsible for 91% of the total costs, and for 44% of the healthcare costs. The mean healthcare cost per patient was €326 (SD 389) during six months. Physiotherapy treatments accounted for 60%. The costs for sick leave contributed to 84% of the total costs. The mean annual total cost was €4139 per patient. Estimated costs for secondary care increased the total costs by one third.ConclusionsThe model applied in this study provides valuable information that can be used in cost evaluations. Costs for secondary care and particularly for sick leave have a major influence on total costs and interventions that can reduce long periods of sick leave are warranted.
Highlights
Painful shoulders pose a substantial socioeconomic burden
In Sweden, health and medical care are organised in three levels: regional medical care, county medical care, and primary care which is organised by the county councils
The aim of this study was to assess the costs associated with healthcare use and loss of productivity caused by shoulder pain in Sweden, by auditing data from the electronic patient records (EPR)
Summary
Painful shoulders pose a substantial socioeconomic burden. A prospective cost-of-illness study was performed to assess the costs associated with healthcare use and loss of productivity in patients with shoulder pain in primary health care in Sweden. A majority of the patients are treated in primary health care [1,2,3]. In Sweden, health and medical care are organised in three levels: regional medical care, county medical care, and primary care which is organised by the county councils. Primary care is intended to meet the needs of most patients for medical treatment, care, preventive measures and rehabilitation. When more specialised care is necessary, patients are referred to the county hospitals. The regional hospitals treat rare and complicated cases. There were very few private care providers in the county at the time of this study. The Swedish Health and Medical Services Act states that priority should be given to those who are
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