Abstract
BackgroundPsychiatric comorbidity is common in back pain patients undergoing disc surgery and increases economic costs in many areas of health. The objective of this study was to analyse psychiatric comorbidity as predictor of direct and indirect costs in back pain patients undergoing disc surgery in a longitudinal study design.MethodsA sample of 531 back pain patients was interviewed after an initial disc surgery (T0), 3 months (T1) and 15 months (T2) using the Composite International Diagnostic Interview to assess psychiatric comorbidity and a modified version of the Client Sociodemographic and Service Receipt Inventory to assess resource utilization and lost productivity for a 3-month period prior interview. Health care utilization was monetarily valued by unit costs and productivity by labour costs. Costs were analysed using random coefficient models and bootstrap techniques.ResultsPsychiatric comorbidity was associated with significantly (p < 0.05) increased direct (+664 Euro) and indirect costs (+808 Euro) at T0. The direct cost difference predominantly resulted from medical health care utilization and was nearly unchanged at T2. Further important cost predictors were clinical variables like the presence of chronic medical disease, the number of previous disc surgeries, and time and gender.ConclusionPsychiatric comorbidity presents an important predictor of direct and indirect costs in back pain patients undergoing disc surgery, even if patients do not utilize mental health care. This effect seems to be stable over time. More attention should be given to psychiatric comorbidity and cost-effective treatments should be applied to treat psychiatric comorbidity in back pain patients undergoing disc surgery to reduce health care utilization and costs associated with psychiatric comorbidity.
Highlights
Psychiatric comorbidity is common in back pain patients undergoing disc surgery and increases economic costs in many areas of health
The aim of this study was to investigate whether psychiatric comorbidity predicts direct and indirect cost in back pain patients undergoing disc surgery and to estimate other predictors for direct and indirect costs, in a prospective study design
Summarized, we found that direct as well as indirect costs were strongly predicted by time and clinical variables including psychiatric comorbidity
Summary
Psychiatric comorbidity is common in back pain patients undergoing disc surgery and increases economic costs in many areas of health. The objective of this study was to analyse psychiatric comorbidity as predictor of direct and indirect costs in back pain patients undergoing disc surgery in a longitudinal study design. Back pain presents a common health problem, which is often associated with disc herniation [1]. It is well known that back pain and back pain treatment outcome are strongly influenced by psychological factors including psychiatric comorbidity on health care costs in patients undergoing disc surgery in a prospective study design. Estimating the costs of an illness is useful to inform decision makers about the economic relevance of a health problem and feasible objectives for interventions. Whereas direct costs refer to the monetary value of utilized resources (e.g. for hospital stays, physician visits or drugs), indirect costs refer to productivity lost due to morbidity or premature mortality
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
