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Back Pain May Lead to Higher Expenses for Other Conditions

'Ballooning' of health needs occurs around the time of an episode of low back pain

THURSDAY, April 29 (HealthDay News) -- Incidents of low back pain are associated with increased expenditures for other health conditions, according to research published in the April 1 issue of Spine.

Ashok Nimgade, M.D., of the Harvard School of Public Health in Boston, and colleagues reviewed health care expenditures in a random sample of 655 patients from a managed health plan with new onset low back pain in 1999, and compared the expenses using 30-, 60-, and 90-day back care time windows before and after the initial low back pain visit.

Compared to the period of one to three months before low back pain initiation, the researchers found that post-initiation average monthly expenses per patient increased for other health conditions. They found that the increase persisted even after making the conservative adjustments of excluding all radiology expenses that occurred coincident with low back pain, billings for non-low back pain conditions that occurred on days of any low back pain visit, and patients with a baseline of low health care utilization before low back pain initiation. They also found that patients with higher expenses for other health conditions were more likely to have been prescribed psychiatric medications.

"Our research specifically highlights how treatment for low back pain must be aligned with other primary care services to somehow prevent a 'ballooning' of health needs around the time of the low back pain episode," the authors conclude. "This is especially important given the shortages in primary care providers and the increasing fragmentation and specialization in the health care system. In addition, our nuanced focus on outpatient services in particular suggests where this separation of purpose may begin."

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