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Source
Sygeplejersken. 1988 Aug 10;88(32):13
Publication Type
Article
Date
Aug-10-1988

Cost-minimisation analysis of three conservative treatment programmes in 180 patients sick-listed for acute low-back pain.

https://arctichealth.org/en/permalink/ahliterature72172
Source
Scand J Prim Health Care. 2000 Mar;18(1):53-7
Publication Type
Article
Date
Mar-2000
Author
T. Seferlis
L. Lindholm
G. Németh
Author Affiliation
Department of Orthopaedics, Karolinska Hospital, Stockholm, Sweden.
Source
Scand J Prim Health Care. 2000 Mar;18(1):53-7
Date
Mar-2000
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Cost Control
Cost-Benefit Analysis
Female
Health Care Costs - statistics & numerical data
Humans
Low Back Pain - economics - therapy
Male
Middle Aged
Outcome Assessment (Health Care)
Prospective Studies
Research Support, Non-U.S. Gov't
Sick Leave - economics
Sweden
Abstract
OBJECTIVE: To perform a cost-minimization analysis of three conservative treatment regimes for acute low-back pain (LBP). DESIGN: A prospective randomized clinical trial. Patients were assigned at random to one of three treatment programmes: General Practitioner Programme (GPP-) controls, Manual Therapy Programme (MTP) or Intensive Training Programme (ITP). SETTING: Primary care and physiotherapists in Stockholm, Sweden. PATIENTS: 180 patients sick-listed for acute LBP. MAIN OUTCOME MEASURES: Direct, indirect and total costs for three treatment programmes. RESULTS: The direct costs for treatment were lowest in the GPP group -- 2744 Swedish crowns (SEK) per patient. More patients in the MTP and ITP underwent operations for disk hernia and radiological investigations than in the GPP. Indirect costs, defined as sick-leave for LBP represent about 90% of the total cost. CONCLUSIONS: With respect to total costs, the findings were similar between the three treatment programmes. The GPP had the lowest direct costs. It is not possible to conclude which treatment programme is to be recommended as a least cost alternative. The strong effect of indirect costs on the total cost stresses that further studies should focus on methods of shortening sick-leave.
PubMed ID
10811045 View in PubMed
Less detail

Economic evaluation of an implementation strategy for the management of low back pain in general practice.

https://arctichealth.org/en/permalink/ahliterature282053
Source
Pain. 2017 May;158(5):891-899
Publication Type
Article
Date
May-2017
Author
Cathrine Elgaard Jensen
Allan Riis
Karin Dam Petersen
Martin Bach Jensen
Kjeld Møller Pedersen
Source
Pain. 2017 May;158(5):891-899
Date
May-2017
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cost-Benefit Analysis
Delivery of Health Care - economics - methods
Denmark
Disease Management
Female
Follow-Up Studies
General Practice - economics - methods
Humans
Linear Models
Low Back Pain - economics - therapy
Male
Middle Aged
Outcome Assessment (Health Care)
Quality of Life
Quality-Adjusted Life Years
Sensitivity and specificity
Young Adult
Abstract
In connection with the publication of a clinical practice guideline on the management of low back pain (LBP) in general practice in Denmark, a cluster randomised controlled trial was conducted. In this trial, a multifaceted guideline implementation strategy to improve general practitioners' treatment of patients with LBP was compared with a usual implementation strategy. The aim was to determine whether the multifaceted strategy was cost effective, as compared with the usual implementation strategy. The economic evaluation was conducted as a cost-utility analysis where cost collected from a societal perspective and quality-adjusted life years were used as outcome measures. The analysis was conducted as a within-trial analysis with a 12-month time horizon consistent with the follow-up period of the clinical trial. To adjust for a priori selected covariates, generalised linear models with a gamma family were used to estimate incremental costs and quality-adjusted life years. Furthermore, both deterministic and probabilistic sensitivity analyses were conducted. Results showed that costs associated with primary health care were higher, whereas secondary health care costs were lower for the intervention group when compared with the control group. When adjusting for covariates, the intervention was less costly, and there was no significant difference in effect between the 2 groups. Sensitivity analyses showed that results were sensitive to uncertainty. In conclusion, the multifaceted implementation strategy was cost saving when compared with the usual strategy for implementing LBP clinical practice guidelines in general practice. Furthermore, there was no significant difference in effect, and the estimate was sensitive to uncertainty.
PubMed ID
28114182 View in PubMed
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Is the chiropractic management of low-back pain the solution? What can physicians learn from the Manga report?

https://arctichealth.org/en/permalink/ahliterature216967
Source
CMAJ. 1994 Nov 1;151(9):1247-9
Publication Type
Article
Date
Nov-1-1994
Author
G S Tardif
Source
CMAJ. 1994 Nov 1;151(9):1247-9
Date
Nov-1-1994
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Canada
Chiropractic
Humans
Low Back Pain - economics - therapy
Notes
Cites: BMJ. 1990 Jun 2;300(6737):1431-72143092
Cites: Acta Orthop Scand Suppl. 1993;251:21-48451976
Cites: CMAJ. 1994 Jun 1;150(11):1878-817802764
Cites: Clin Orthop Relat Res. 1972 Sep;87:209-164263297
Cites: J Rheumatol. 1988 Oct;15(10):1557-642974489
Cites: J Psychosom Res. 1980;24(6):297-3016451689
Cites: Br Med J (Clin Res Ed). 1984 Sep 22;289(6447):739-416236867
Cites: J Health Soc Behav. 1987 Jun;28(2):131-92956317
Cites: J Psychosom Res. 1988;32(3):277-832972831
Erratum In: Can Med Assoc J 1994 Dec 15;151(12):1697
PubMed ID
7954171 View in PubMed
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[Medical treatment of back problems--10 times more expensive than treatment by chiropractors].

https://arctichealth.org/en/permalink/ahliterature224346
Source
Tidsskr Nor Laegeforen. 1992 Feb 10;112(4):526
Publication Type
Article
Date
Feb-10-1992
Author
O. Stokke
Source
Tidsskr Nor Laegeforen. 1992 Feb 10;112(4):526
Date
Feb-10-1992
Language
Norwegian
Publication Type
Article
Keywords
Back Pain - economics - therapy
Chiropractic - economics
Humans
Norway
PubMed ID
1532465 View in PubMed
Less detail

Mini-intervention for subacute low back pain: a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature186217
Source
Spine (Phila Pa 1976). 2003 Mar 15;28(6):533-40; discussion 540-1
Publication Type
Article
Date
Mar-15-2003
Author
Kaija Karjalainen
Antti Malmivaara
Timo Pohjolainen
Heikki Hurri
Pertti Mutanen
Pekka Rissanen
Helena Pahkajärvi
Heikki Levon
Hanna Karpoff
Risto Roine
Author Affiliation
Department of Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland. kaija.karjalainen@occuphealth.fi
Source
Spine (Phila Pa 1976). 2003 Mar 15;28(6):533-40; discussion 540-1
Date
Mar-15-2003
Language
English
Publication Type
Article
Keywords
Acute Disease
Adult
Disability Evaluation
Exercise
Female
Finland
Follow-Up Studies
Health Care Costs - statistics & numerical data
Humans
Low Back Pain - economics - therapy
Male
Middle Aged
Outcome Assessment (Health Care) - economics - statistics & numerical data
Pain Measurement - statistics & numerical data
Patient Satisfaction - statistics & numerical data
Physical Therapy Modalities
Quality of Life
Sick Leave - statistics & numerical data
Workplace
Abstract
Randomized controlled trial.
To investigate the effectiveness and costs of a mini-intervention, provided in addition to the usual care, and the incremental effect of a work site visit for patients with subacute disabling low back pain.
There is lack of data on cost-effectiveness of brief interventions for patients with prolonged low back pain.
A total of 164 patients with subacute low back pain were randomized to a mini-intervention group (A), a work site visit group (B), or a usual care group (C). Groups A (n = 56) and B (n = 51) underwent one assessment by a physician plus a physiotherapist. Group B received a work site visit in addition. Group C served as controls (n = 57) and was treated in municipal primary health care. All patients received a leaflet on back pain. Pain, disability, specific and generic health-related quality of life, satisfaction with care, days on sick leave, and use and costs of health care consumption were measured at 3-, 6-, and 12-month follow-ups.
During follow-up, fewer subjects had daily pain in Groups A and B than in Group C (Group A Group C, = 0.002; Group B Group C, = 0.030). In Group A, pain was less bothersome (Group A Group C, = 0.032) and interfered less with daily life (Group A Group C, = 0.040) than among controls. Average days on sick leave were 19 in Group A, 28 in Group B, and 41 in Group C (Group A Group C, = 0.019). Treatment satisfaction was better in the intervention groups than among the controls, and costs were lowest in the mini-intervention group.
Mini-intervention reduced daily back pain symptoms and sickness absence, improved adaptation to pain and patient satisfaction among patients with subacute low back pain, without increasing health care costs. A work site visit did not increase effectiveness.
PubMed ID
12642757 View in PubMed
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Reduced health resource use after acupuncture for low-back pain.

https://arctichealth.org/en/permalink/ahliterature129778
Source
J Altern Complement Med. 2011 Nov;17(11):1015-9
Publication Type
Article
Date
Nov-2011
Author
Sabine Moritz
Ming F Liu
Badri Rickhi
Tracy J Xu
Patricia Paccagnan
Hude Quan
Author Affiliation
Canadian Institute of Natural and Integrative Medicine, Calgary, Alberta, Canada. s.moritz@cinim.org
Source
J Altern Complement Med. 2011 Nov;17(11):1015-9
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Acupuncture Therapy - economics
Alberta
Case-Control Studies
Cost of Illness
Female
Health Care Costs
Health Resources - economics - utilization
Health Services - economics - utilization
Humans
Low Back Pain - economics - therapy
Male
Middle Aged
Office Visits - economics - utilization
Retrospective Studies
Abstract
Acupuncture is commonly used to treat low-back pain (LBP) and clinical trials have demonstrated its efficacy. However, less is known about how the utilization of acupuncture impacts public health service utilization in the real world. This study investigates the association between acupuncture utilization for LBP and health care utilization by assessing whether patients who undergo acupuncture subsequently use fewer health care resources and whether those patients differ in their health care use from the general population with LBP.
This study employed the design of a two-group pre/post secondary data analysis.
There were two study populations. To identify patients who received acupuncture for LBP in 2000, patient charts at Alberta registered acupuncture clinics were reviewed. The comparison group was identified from the Alberta physician claims administrative database. Acupuncture group cases were matched with four comparison cases from the general population with LBP based on gender and age.
Number of physician visits and physician service cost for LBP-related services for 1 year pre- and postacupuncture treatment period were calculated from the physician claims data for both study groups.
For the 201 cases and 804 controls, the mean age was 48 years and 54% were female. The number of physician visits for the 1-year period postacupuncture decreased 49% for the acupuncture group (p
Notes
Comment In: J Altern Complement Med. 2013 Jun;19(6):59823215627
PubMed ID
22070438 View in PubMed
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Structured physiotherapy including a work place intervention for patients with neck and/or back pain in primary care: an economic evaluation.

https://arctichealth.org/en/permalink/ahliterature302772
Source
Eur J Health Econ. 2019 Mar; 20(2):317-327
Publication Type
Journal Article
Multicenter Study
Randomized Controlled Trial
Date
Mar-2019
Author
Sanjib Saha
Birgitta Grahn
Ulf-G Gerdtham
Kjerstin Stigmar
Sara Holmberg
Johan Jarl
Author Affiliation
Health Economics Unit, Department of Clinical Science (Malmö), Lund University, Medicon Village, Scheelevägen 2, 22381, Lund, Sweden. sanjib.saha@med.lu.se.
Source
Eur J Health Econ. 2019 Mar; 20(2):317-327
Date
Mar-2019
Language
English
Publication Type
Journal Article
Multicenter Study
Randomized Controlled Trial
Keywords
Adult
Back Pain - economics - therapy
Cost-Benefit Analysis
Female
Humans
Male
Middle Aged
Neck Pain - economics - therapy
Patient Satisfaction - economics
Physical Therapy Modalities - economics
Primary Health Care
Quality-Adjusted Life Years
Recovery of Function
Return to work
Sick Leave - economics
Sweden
Treatment Outcome
Workplace
Abstract
A cluster-randomized controlled trial, WorkUp, was conducted for working-aged patients at risk of sick leave or on short-term sick leave due to acute/subacute neck and/or back pain in Sweden. The purpose of WorkUp was to facilitate participants to stay at work or in case of sick leave, return-to-work. The aim of this study was to study whether the WorkUp trial was cost-effective. Patients in the intervention and reference group received structured evidence-based physiotherapy, while patients in the intervention group also received a work place dialogue with the employer as an add-on. The participants, 352 in total, were recruited from 20 physiotherapeutic units in primary healthcare in southern Sweden. The economic evaluation was performed both from a healthcare and a societal perspective with a 12-month time frame with extensive univariate sensitivity analyses. Results were presented as incremental cost-effectiveness ratios (ICER) with outcomes measured as quality-adjusted life-years (QALY) and proportion working for at least 4 weeks in a row without reported sick leave at 12-month follow-up. From the healthcare perspective, the ICER was €23,606 (2013 price year) per QALY gain. From the societal perspective the intervention was dominating, i.e.. less costly and more effective than reference care. Bootstrap analysis showed that the probability of the intervention to be cost-effective at €50,000 willingness-to-pay per QALY was 85% from the societal perspective. Structured evidence-based physiotherapeutic care together with workplace dialogue is a cost-effective alternative from both a societal and a healthcare perspective for acute/subacute neck and/or back pain patients.Trial registration ClinicalTrials.gov: NCT02609750.
PubMed ID
30171489 View in PubMed
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8 records – page 1 of 1.