title: [Multidisciplinary outpatient care program vs. usual care : Cost-benefit analysis in patients with chronic low back pain].
abstract: BACKGROUND
  Chronic low back pain (CLBP) is a major health problem in industrialized nations and is associated with very high total costs. These costs are split between direct costs brought about by the utilization of health care services and indirect costs due to back pain-related loss of productivity. Despite the existence of some evidence about the effectiveness of a multidisciplinary outpatient care programmes in Germany, the economic benefit of these programmes has not yet been studied in detail.
  
  
  OBJECTIVE
  To provide an economic evaluation of the cost benefits of a multidisciplinary outpatient care programme for patients with chronic low back pain (CLBP) compared to those undergoing conventional care.
  
  
  METHODS
  An economic evaluation was performed in 514 patients who have been diagnosed with LBP. Two interventions will be compared: (1) a multidisciplinary outpatient care programme consisting of education, activity programmes, cognitive behavioural therapy, work hardening and functional restoration and (2) the usual noninvasive care provided by medical specialists and health care professionals. In all, 257 patients were involved in a 4 week multidisciplinary outpatient care programme, while the other 257 were subject to conventional care.
  
  
  RESULTS
  The total costs per patient were estimated to be <euro>10,584.14 (±<euro> 9,730.87) after 1 year in the group with the multidisciplinary care programme. The results show a significant reduction in the total amount of costs <euro>3,161.63 (range <euro>2,845.30-3,477.96) compared to the usual care group. However, the direct costs are minor (6-12%) compared to the indirect costs (80-93%).
  
  
  CONCLUSIONS
  This study provides important information which is of value for decision-making and making an adequate allocation of medical resources for patients with CLBP. A multidisciplinary outpatient care programme can facilitate rapid return to work.
authors.affiliation: Park-Klinik Weissensee, Schönstr. 80, 13086, Berlin, Deutschland, broemme@park-klinik.com.
authors.forename: J
authors.initials: J
authors.lastname: Brömme
authors.forename: M
authors.initials: M
authors.lastname: Mohokum
authors.forename: A C
authors.initials: AC
authors.lastname: Disch
authors.forename: U
authors.initials: U
authors.lastname: Marnitz
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000191:economics*; D003131:Combined Modality Therapy / Q000191:economics*; D003362:Cost-Benefit Analysis / Q000191:economics*; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D000070516:Intersectoral Collaboration; D017116:Low Back Pain / Q000191:economics* / Q000628:therapy*; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D014942:Workers' Compensation / Q000191:economics