title: The trend in total cost of back pain in The Netherlands in the period 2002 to 2007.
abstract: METHODS
  Cost of illness study.
  
  
  OBJECTIVE
  To investigate the total costs of back pain in The Netherlands over the years 2002 to 2007.
  
  
  BACKGROUND
  In 1991, the cost of back pain to the Dutch society was estimated at € 4.2 billion. In the last two decades, new laws regarding health insurance and sickness benefits and new guidelines for health care professionals have been introduced and may have affected the societal costs of back pain in The Netherlands.
  
  
  METHODS
  We conducted a cost-of-illness study in which we gathered relevant available data from national registries, reports of research institutes, descriptive studies, and occupational health care authorities to estimate the total cost of back pain to the Dutch society for the years 2002 to 2007. RESULTS.: The total costs of back pain decreased from € 4.3 billion in 2002 to € 3.5 billion in 2007. The share of these costs was about 0.9% of the gross national product (GNP) in 2002 and 0.6% of GNP in 2007. The ratio between direct and indirect costs did not change noticeably over the years, that is, 12% for direct and 88% for indirect costs.
  
  
  CONCLUSIONS
  The total societal costs of back pain have decreased since 1991 and also between 2002 and 2007. Although Dutch policy interventions to lower the indirect costs seem to be successful in the last decades, costs of back pain are still substantial, and indirect costs represent the majority of these costs. Policy interventions and implementation of cost-effective interventions focusing on return-to-work management for back pain in health care is important to further decrease the economic burden of back pain on society.
authors.affiliation: EMGO Institute for Health and Care Research, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Ludeke C
authors.initials: LC
authors.lastname: Lambeek
authors.forename: Maurits W
authors.initials: MW
authors.lastname: van Tulder
authors.forename: Ilse C S
authors.initials: IC
authors.lastname: Swinkels
authors.forename: Lando L J
authors.initials: LL
authors.lastname: Koppes
authors.forename: Johannes R
authors.initials: JR
authors.lastname: Anema
authors.forename: Willlem
authors.initials: W
authors.lastname: van Mechelen
mesh_terms: D000041:Absenteeism; D000488:Allied Health Personnel / Q000191:economics / Q000639:trends; D000553:Ambulatory Care / Q000191:economics / Q000639:trends; D000700:Analgesics / Q000191:economics / Q000627:therapeutic use; D001416:Back Pain / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D017281:Cost of Illness; D003955:Diagnostic Tests, Routine / Q000191:economics / Q000639:trends; D016527:Drug Costs / Q000639:trends; D058006:General Practice / Q000191:economics / Q000639:trends; D059066:Gross Domestic Product / Q000639:trends; D017048:Health Care Costs / Q000639:trends*; D006302:Health Services Research; D017721:Hospital Costs / Q000639:trends; D006801:Humans; D018868:Insurance, Disability / Q000191:economics / Q000639:trends; D009426:Netherlands / Q000453:epidemiology; D016272:Occupational Health; D019637:Orthopedic Procedures / Q000191:economics / Q000639:trends; D018582:Sick Leave / Q000191:economics / Q000639:trends; D013997:Time Factors
chemical_list: D000700:Analgesics