title: Healthcare utilization of back pain patients: results of a claims data analysis.
abstract: OBJECTIVE
  The high life-time prevalence of chronic back pain (25-30% according to surveys in small samples) suggests that it may be a major source of healthcare cost and that prevention of chronic back pain may be both ethically and economically recommendable. To obtain valid economic data on the cost of back pain in Germany, a retrospective claims data analysis was performed.
  
  
  METHODS
  Using data from 2006 of 5.2 million beneficiaries of a German statutory health insurance fund (DAK Unternehmen Leben) covering ~7% of the German population, mean value analyses report on key healthcare utilization figures from a sickness funds? perspective. In contrast to other studies, cost data are primary data and not extrapolated, but clinical characteristics include surrogate markers as no clinical case descriptions were available.
  
  
  RESULTS
  Based on previously investigated diagnosis patterns three types of back pain could be identified: (other) specific back pain (n=211,216), pain due to spinal disk disease (n=195,712), and non-specific back pain (n=534,272). Of all back pain patients, 25.8% were identified as at risk to develop chronic pain, where only 2.6% were detected as patients with chronic back pain. Mean resource utilization and related healthcare costs were significantly higher for beneficiaries with indicators for chronic back pain than for beneficiaries with only risk factors for developing chronic back pain. This especially holds for outpatient analgesic prescriptions (p<0.05), for in-hospital multimodal pain therapy (p<0.05), for in-hospital care in general (p<0.05), as well as for direct cost of care (p<0.05).
  
  
  CONCLUSIONS
  The results show the potential that could be made accessible by an early detection of back pain patients who bear a risk of pain becoming chronic, both in terms of quality-of-life as well as in financial terms.
authors: German Society for Pain Therapy e.V. (DGS), Oberursel, Germany.
authors: G
authors: G
authors: Müller-Schwefe
authors: A
authors: A
authors: Freytag
authors: A
authors: A
authors: Höer
authors: G
authors: G
authors: Schiffhorst
authors: A
authors: A
authors: Becker
authors: H-R
authors: HR
authors: Casser
authors: G
authors: G
authors: Glaeske
authors: R
authors: R
authors: Thoma
authors: R-D
authors: RD
authors: Treede
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000191:economics* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D017281:Cost of Illness; D005260:Female; D005858:Germany; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013122:Spinal Diseases / Q000191:economics / Q000628:therapy; D055815:Young Adult