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Healthcare utilization and related costs among older people seeking primary care due to back pain: findings from the BACE-N cohort study

Munk Killingmo, Rikke; Storheim, Kjersti; Van Der Windt, Danielle; Zolic-Karlsson, Zinajda; Nesse Vigdal, Ørjan; Kretz, Lise; Cvancarova Småstuen, Milada; Grotle, Margreth

Healthcare utilization and related costs among older people seeking primary care due to back pain: findings from the BACE-N cohort study Thumbnail


Authors

Rikke Munk Killingmo

Kjersti Storheim

Zinajda Zolic-Karlsson

Ørjan Nesse Vigdal

Lise Kretz

Milada Cvancarova Småstuen

Margreth Grotle



Abstract

OBJECTIVES: To describe healthcare utilization and estimate associated costs during 1?year of follow-up among older people seeking primary care due to a new episode back pain and to describe healthcare utilization across patients with different risk profiles stratified using the StarT Back Screening Tool (SBST). DESIGN: Prospective cohort study. PARTICIPANTS AND SETTING: A total of 452 people aged =55 years seeking Norwegian primary care with a new episode of back pain were included. OUTCOME MEASURES: The primary outcome of this study was total cost of healthcare utilization aggregated for 1?year of follow-up. Secondary outcomes included components of healthcare utilization aggregated for 1?year of follow-up. Healthcare utilization was self-reported and included: primary care consultations, medications, examinations, hospitalisation, rehabilitation stay, and operations. Costs were estimated based on unit costs collected from national pricelists. Healthcare utilization across patients with different SBST risk profiles was compared using Kruskal-Wallis test, post hoc Mann-Whitney U tests and Bonferroni adjustment. RESULTS: In total, 438 patients were included in the analysis. Mean (BCa 95%?CI) total cost per patient over 1?year was €825 (682-976). Median (BCa 95%?CI) total cost was €364 (307-440). The largest cost category was primary care consultations, accounting for 56% of total costs. Imaging rate was 34%. The most commonly used medication was paracetamol (27%-35% of patients). Medium- and high-risk patients had a significantly higher degree of healthcare utilization compared with low-risk patients (p<0.030). CONCLUSION: This study estimated a 1?year mean and median cost of healthcare utilization of €825 and €364, respectively. Patients within the top 25th percentile accounted for 77% of all costs. Patients classified as medium risk and high risk had a significantly higher degree of healthcare utilization compared with patients classified as low risk. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT04261309, results.

Journal Article Type Article
Acceptance Date May 15, 2022
Online Publication Date Jun 20, 2022
Publication Date Jun 20, 2022
Publicly Available Date Mar 29, 2024
Journal BMJ Open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 12
Issue 6
Article Number ARTN e057778
DOI https://doi.org/10.1136/bmjopen-2021-057778
Keywords back pain; primary care; BACE-N
Publisher URL https://bmjopen.bmj.com/content/12/6/e057778.info

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