Quality of Life and Cost of Care of Back Pain Patients in Finnish General Practice

Hemmilä, Heikki M.

doi:10.1097/00007632-200203150-00015

Cited by 38 publications

(15 citation statements)

References 23 publications

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“…Productivity changes (items 14 and 15) are appropriate for studies using the societal perspective. Eight studies included the costs of changes in productivity from improvement in back or leg pain [47,82], neck pain [27], migraine [32], anxiety [44], ankylosing spondilitis [51], psoriasis [49], and children's rhinopharyngitis [41]. All but one [49] reported these amounts separate from total costs.…”

Section: Resultsmentioning

confidence: 99%

Is complementary and alternative medicine (CAM) cost-effective? a systematic review

Herman

Craig

Caspi

2005

BMC Complement Altern Med

185

121

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BackgroundOut-of-pocket expenditures of over $34 billion per year in the US are an apparent testament to a widely held belief that complementary and alternative medicine (CAM) therapies have benefits that outweigh their costs. However, regardless of public opinion, there is often little more than anecdotal evidence on the health and economic implications of CAM therapies. The objectives of this study are to present an overview of economic evaluation and to expand upon a previous review to examine the current scope and quality of CAM economic evaluations.MethodsThe data sources used were Medline, AMED, Alt-HealthWatch, and the Complementary and Alternative Medicine Citation Index; January 1999 to October 2004. Papers that reported original data on specific CAM therapies from any form of standard economic analysis were included. Full economic evaluations were subjected to two types of quality review. The first was a 35-item checklist for reporting quality, and the second was a set of four criteria for study quality (randomization, prospective collection of economic data, comparison to usual care, and no blinding).ResultsA total of 56 economic evaluations (39 full evaluations) of CAM were found covering a range of therapies applied to a variety of conditions. The reporting quality of the full evaluations was poor for certain items, but was comparable to the quality found by systematic reviews of economic evaluations in conventional medicine. Regarding study quality, 14 (36%) studies were found to meet all four criteria. These exemplary studies indicate CAM therapies that may be considered cost-effective compared to usual care for various conditions: acupuncture for migraine, manual therapy for neck pain, spa therapy for Parkinson's, self-administered stress management for cancer patients undergoing chemotherapy, pre- and post-operative oral nutritional supplementation for lower gastrointestinal tract surgery, biofeedback for patients with "functional" disorders (eg, irritable bowel syndrome), and guided imagery, relaxation therapy, and potassium-rich diet for cardiac patients.ConclusionWhereas the number and quality of economic evaluations of CAM have increased in recent years and more CAM therapies have been shown to be of good value, the majority of CAM therapies still remain to be evaluated.

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Section: Resultsmentioning

confidence: 99%

Is complementary and alternative medicine (CAM) cost-effective? a systematic review

Herman

Craig

Caspi

2005

BMC Complement Altern Med

185

121

View full text Add to dashboard Cite

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“…The biggest concentration of full economic evaluations (19 in number) pertained to the use of NCCAM's definition of manipulative and body-based practices (eg, chiropractic, osteopathic manipulation, massage, etc) for the treatment of back pain. [53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72] However, even this subgroup is fairly heterogeneous in terms of the therapy (or therapies) tested and/or the type of back pain treated. Eight of these comparisons involved chiropractic care for back pain; one for chronic, 53 one for acute 57 and six for either type.…”

Section: Unit Of Health Outcome Monetary Units (Eg Us$) Natural Unitmentioning

confidence: 99%

“…57 The last two studies evaluated a musculoskeletal physician (treatment 'with a combination of manual therapy, injections, acupuncture and other pain management techniques') for orthopaedic referrals; 54 and a Finnish folk medicine practice called 'bone setting' for the treatment of patients with chronic back pain. 61 Table 3 shows the results of the application of the 35-item BMJ checklist to the full economic evaluations published 2001-2010. 41 On average, the number of †Totals across (down) columns will not add to numbers in the totals column (row) due to individual studies addressing more than one CIM therapy (patients in more than one group).…”

Section: Unit Of Health Outcome Monetary Units (Eg Us$) Natural Unitmentioning

confidence: 99%

Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations

et al. 2012

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ObjectiveA comprehensive systematic review of economic evaluations of complementary and integrative medicine (CIM) to establish the value of these therapies to health reform efforts.Data sourcesPubMed, CINAHL, AMED, PsychInfo, Web of Science and EMBASE were searched from inception through 2010. In addition, bibliographies of found articles and reviews were searched, and key researchers were contacted.Eligibility criteria for selecting studiesStudies of CIM were identified using criteria based on those of the Cochrane complementary and alternative medicine group. All studies of CIM reporting economic outcomes were included.Study appraisal methodsAll recent (and likely most cost-relevant) full economic evaluations published 2001–2010 were subjected to several measures of quality. Detailed results of higher-quality studies are reported.ResultsA total of 338 economic evaluations of CIM were identified, of which 204, covering a wide variety of CIM for different populations, were published 2001–2010. A total of 114 of these were full economic evaluations. And 90% of these articles covered studies of single CIM therapies and only one compared usual care to usual care plus access to multiple licensed CIM practitioners. Of the recent full evaluations, 31 (27%) met five study-quality criteria, and 22 of these also met the minimum criterion for study transferability (‘generalisability’). Of the 56 comparisons made in the higher-quality studies, 16 (29%) show a health improvement with cost savings for the CIM therapy versus usual care. Study quality of the cost-utility analyses (CUAs) of CIM was generally comparable to that seen in CUAs across all medicine according to several measures, and the quality of the cost-saving studies was slightly, but not significantly, lower than those showing cost increases (85% vs 88%, p=0.460).ConclusionsThis comprehensive review identified many CIM economic evaluations missed by previous reviews and emerging evidence of cost-effectiveness and possible cost savings in at least a few clinical populations. Recommendations are made for future studies.

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“…Kostenuntersuchungen über den chronischen unspezifischen Kreuzschmerz existieren [8][9][10][11][12][13][14][15][16][17]. Viele Untersuchungen stellen relative Kostenvergleiche unterschiedlicher Therapieformen dar und sind daher nicht mit der gegenständlichen Zielsetzung zu vergleichen.…”

Section: Introductionunclassified

Kosten des chronischen unspezifischen Kreuzschmerzes in Österreich – eine Untersuchung an Patienten in aktueller Behandlung

Wagner

2012

Wien Med Wochenschr

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The objective of this pilot study was to evaluate the annual direct costs of chronic non-specific low back pain in Austria in patients currently undergoing in-patient rehabilitation or out-patient treatment. 48 patients participated in the study. Average direct medical costs per patient year as paid by the sick funds were € 1443,-, in-patient rehabilitation was the single most expensive direct cost factor. Non-medical costs, that is, mainly household assistance and home adaptations, were € 394,-; deductibles and non-reimbursable medical costs were € 329. On average, patients had 2.7 co-morbidities (men: 2.2; women: 2.9).

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Quality of Life and Cost of Care of Back Pain Patients in Finnish General Practice

Abstract: A third of the direct back pain costs were spent on complementary therapies. The use of health care services and absenteeism tended to decrease after a course of physiotherapy. Physiotherapy and bone setting seemed able to improve the quality of life of patients with prolonged back pain.

Cited by 38 publications

References 23 publications

Is complementary and alternative medicine (CAM) cost-effective? a systematic review

Is complementary and alternative medicine (CAM) cost-effective? a systematic review

Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations

Kosten des chronischen unspezifischen Kreuzschmerzes in Österreich – eine Untersuchung an Patienten in aktueller Behandlung

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