Modifiable prognostic factors of high costs related to healthcare utilization among older people seeking primary care due to back pain: an identification and replication study.

Aged Back Pain Humans Middle Aged Patient Acceptance of Health Care Primary Health Care Prognosis Quality of Life
Back pain Costs Healthcare utilization Prognostic factor research

Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
18 Jun 2022
Historique:
received: 17 12 2021
accepted: 13 06 2022
entrez: 18 6 2022
pubmed: 19 6 2022
medline: 22 6 2022
Statut: epublish

Résumé

Back pain is an extensive burden to our healthcare system, yet few studies have explored modifiable prognostic factors associated with high costs related to healthcare utilization, especially among older back pain patients. The aims of this study were to identify modifiable prognostic factors for high costs related to healthcare utilization among older people seeking primary care with a new episode of back pain; and to replicate the identified associations in a similar cohort, in a different country. Data from two cohort studies within the BACE consortium were used, including 452 and 675 people aged ≥55 years seeking primary care with a new episode of back pain. High costs were defined as costs in the top 25th percentile. Healthcare utilization was self-reported, aggregated for one-year of follow-up and included: primary care consultations, medications, examinations, hospitalization, rehabilitation stay and operations. Costs were estimated based on unit costs collected from national pricelists. Nine potential modifiable prognostic factors were selected based on previous literature. Univariable and multivariable binary logistic regression models were used to identify and replicate associations (crude and adjusted for selected covariates) between each modifiable prognostic factor and high costs related to healthcare utilization. Four modifiable prognostic factors associated with high costs related to healthcare utilization were identified and replicated: a higher degree of pain severity, disability, depression, and a lower degree of physical health-related quality of life. Kinesiophobia and recovery expectations showed no prognostic value. There were inconsistent results across the two cohorts with regards to comorbidity, radiating pain below the knee and mental health-related quality of life. The factors identified in this study may be future targets for intervention with the potential to reduce high costs related to healthcare utilization among older back pain patients. ClinicalTrials.gov NCT04261309, 07 February 2020. Retrospectively registered.

Sections du résumé

BACKGROUND BACKGROUND
Back pain is an extensive burden to our healthcare system, yet few studies have explored modifiable prognostic factors associated with high costs related to healthcare utilization, especially among older back pain patients. The aims of this study were to identify modifiable prognostic factors for high costs related to healthcare utilization among older people seeking primary care with a new episode of back pain; and to replicate the identified associations in a similar cohort, in a different country.
METHODS METHODS
Data from two cohort studies within the BACE consortium were used, including 452 and 675 people aged ≥55 years seeking primary care with a new episode of back pain. High costs were defined as costs in the top 25th percentile. Healthcare utilization was self-reported, aggregated for one-year of follow-up and included: primary care consultations, medications, examinations, hospitalization, rehabilitation stay and operations. Costs were estimated based on unit costs collected from national pricelists. Nine potential modifiable prognostic factors were selected based on previous literature. Univariable and multivariable binary logistic regression models were used to identify and replicate associations (crude and adjusted for selected covariates) between each modifiable prognostic factor and high costs related to healthcare utilization.
RESULTS RESULTS
Four modifiable prognostic factors associated with high costs related to healthcare utilization were identified and replicated: a higher degree of pain severity, disability, depression, and a lower degree of physical health-related quality of life. Kinesiophobia and recovery expectations showed no prognostic value. There were inconsistent results across the two cohorts with regards to comorbidity, radiating pain below the knee and mental health-related quality of life.
CONCLUSION CONCLUSIONS
The factors identified in this study may be future targets for intervention with the potential to reduce high costs related to healthcare utilization among older back pain patients.
TRIAL REGISTRATION BACKGROUND
ClinicalTrials.gov NCT04261309, 07 February 2020. Retrospectively registered.

Identifiants

DOI: 10.1186/s12913-022-08180-2 PMID: 35717179 PMC: PMC9206382
pubmed: 35717179
doi: 10.1186/s12913-022-08180-2
pii: 10.1186/s12913-022-08180-2
pmc: PMC9206382
doi:

Banques de données

ClinicalTrials.gov
['NCT04261309']

Types de publication

Clinical Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

793

Informations de copyright

© 2022. The Author(s).

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Auteurs

Rikke Munk Killingmo (RM)

Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway. rikke@oslomet.no.

Alessandro Chiarotto (A)

Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.

Danielle A van der Windt (DA)

School of Medicine, Keele University, Keele, UK.

Kjersti Storheim (K)

Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.
Research and Communication Unit for Musculoskeletal Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.

Sita M A Bierma-Zeinstra (SMA)

Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
Department of Orthopedics, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.

Milada C Småstuen (MC)

Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.

Zinajda Zolic-Karlsson (Z)

HTA and Reimbursement at Norwegian Medicines Agency, Oslo, Norway.

Ørjan N Vigdal (ØN)

Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.

Bart W Koes (BW)

Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark.

Margreth Grotle (M)

Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.
Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Modifiable prognostic factors of high costs...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Dorsalgie › Modifiable prognostic factors of high costs...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Modifiable prognostic factors of high costs...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Modifiable prognostic factors of high costs...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Attitude envers la santé › Adhésion et observance thérapeutiques › Acceptation des soins par les patients › Modifiable prognostic factors of high costs...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Soins de santé primaires › Modifiable prognostic factors of high costs...
questionsmedicales.fr › Diagnostic › Pronostic › Modifiable prognostic factors of high costs...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Mesures épidémiologiques › Démographie › État de santé › Qualité de vie › Modifiable prognostic factors of high costs...