Psychiatric Comorbidity Affects Costs in Severe Back Pain

Psychiatric comorbidity influences high direct, indirect costs for patients undergoing disc surgery

FRIDAY, Aug. 12 (HealthDay News) -- Patients with severe back pain undergoing disc surgery have high direct and indirect costs, which are influenced by psychiatric comorbidity, according to a study published in the July issue of The Spine Journal.

Alexander Konnopka, M.D., from the University Clinics Hamburg-Eppendorf in Germany, and colleagues assessed the effect of psychiatric comorbidity on health care costs and loss of productivity in 305 patients with back pain undergoing disc surgery. Patients were interviewed to assess psychiatric comorbidity using the German version of the Composite International Diagnostic Interview and questionnaires were used to assess resource utilization and loss of productivity for a three-month period prior to the disc surgery. Monetary value and productivity of health care resources were evaluated by unit cost and labor cost, respectively.

The investigators found that back pain was correlated with mean three-month direct health care costs, ranging from €5,534 (lumbar disc herniation without psychiatric comorbidity) to €8,507 (cervical disc herniation with psychiatric comorbidity). Between 51 and 79 percent of the costs were due to disc surgery. Mean indirect costs varied between €7,589 and €8,492. Increased direct costs in lumbar disc herniation were significantly correlated with psychiatric comorbidity, with €7,042 and €5,534 for patients with and without psychiatric comorbidity, respectively. Increments of €851 in direct costs and €1,636 in total costs for psychiatric comorbidity, which resulted from nonpsychiatric health care utilization were seen.

"Severe back pain is associated with high direct and indirect costs, which are influenced by the presence of psychiatric comorbidity," the authors write.

Abstract
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