Healthcare utilization and related costs among older people seeking primary care due to back pain: findings from the BACE-N cohort study
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...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e057778.full |
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| author | Danielle van der Windt Milada Cvancarova Småstuen Kjersti Storheim Margreth Grotle Zinajda Zolic-Karlsson Ørjan Nesse Vigdal Rikke Munk Killingmo Lise Kretz |
| author_facet | Danielle van der Windt Milada Cvancarova Småstuen Kjersti Storheim Margreth Grotle Zinajda Zolic-Karlsson Ørjan Nesse Vigdal Rikke Munk Killingmo Lise Kretz |
| author_sort | Danielle van der Windt |
| collection | DOAJ |
| description | 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 |
| format | Article |
| id | doaj-art-b6c20081182d4511b0f2def001c48b31 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-b6c20081182d4511b0f2def001c48b312025-01-24T03:20:10ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-057778Healthcare utilization and related costs among older people seeking primary care due to back pain: findings from the BACE-N cohort studyDanielle van der Windt0Milada Cvancarova Småstuen1Kjersti Storheim2Margreth Grotle3Zinajda Zolic-Karlsson4Ørjan Nesse Vigdal5Rikke Munk Killingmo6Lise Kretz7School of Medicine, Keele University, Keele, UK1 Department of Medicine, Vestfold Hospital Trust, The Morbid Obesity Centre (MOC), Tønsberg, Norway7 Research and Communication Unit for Musculoskeletal Health (FORMI), Oslo, NorwayDepartment of Physiotherapy, Oslo Metropolitan University, Oslo, NorwayHTA and Reimbursement, Norwegian Medicines Agency, Oslo, NorwayDepartment of Physiotherapy, Oslo Metropolitan University, Oslo, NorwayDepartment of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, NorwayDepartment of Physiotherapy, Oslo Metropolitan University, Oslo, NorwayObjectives 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, resultshttps://bmjopen.bmj.com/content/12/6/e057778.full |
| spellingShingle | Danielle van der Windt Milada Cvancarova Småstuen Kjersti Storheim Margreth Grotle Zinajda Zolic-Karlsson Ørjan Nesse Vigdal Rikke Munk Killingmo Lise Kretz Healthcare utilization and related costs among older people seeking primary care due to back pain: findings from the BACE-N cohort study BMJ Open |
| title | Healthcare utilization and related costs among older people seeking primary care due to back pain: findings from the BACE-N cohort study |
| title_full | Healthcare utilization and related costs among older people seeking primary care due to back pain: findings from the BACE-N cohort study |
| title_fullStr | Healthcare utilization and related costs among older people seeking primary care due to back pain: findings from the BACE-N cohort study |
| title_full_unstemmed | Healthcare utilization and related costs among older people seeking primary care due to back pain: findings from the BACE-N cohort study |
| title_short | Healthcare utilization and related costs among older people seeking primary care due to back pain: findings from the BACE-N cohort study |
| title_sort | healthcare utilization and related costs among older people seeking primary care due to back pain findings from the bace n cohort study |
| url | https://bmjopen.bmj.com/content/12/6/e057778.full |
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