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Modifiable prognostic factors of high costs related to healthcare utilization among older people seeking primary care due to back pain: an identification and replication study

Killingmo, Rikke Munk; Chiarotto, Alessandro; van der Windt, Danielle A.; Storheim, Kjersti; Bierma-Zeinstra, Sita M. A.; Småstuen, Milada C; Zolic-Karlsson, Zinajda; Vigdal, Ørjan N.; Koes, Bart W.; Grotle, Margreth

Modifiable prognostic factors of high costs related to healthcare utilization among older people seeking primary care due to back pain: an identification and replication study Thumbnail


Authors

Rikke Munk Killingmo

Alessandro Chiarotto

Kjersti Storheim

Sita M. A. Bierma-Zeinstra

Milada C Småstuen

Zinajda Zolic-Karlsson

Ørjan N. Vigdal

Bart W. Koes

Margreth Grotle



Abstract

<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Back pain is an extensive burden to our healthcare system, yet few studies have explored modifiable prognostic factors associated with high costs related to healthcare utilization, especially among older back pain patients. The aims of this study were to identify modifiable prognostic factors for high costs related to healthcare utilization among older people seeking primary care with a new episode of back pain; and to replicate the identified associations in a similar cohort, in a different country.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Data from two cohort studies within the BACE consortium were used, including 452 and 675 people aged =55?years seeking primary care with a new episode of back pain. High costs were defined as costs in the top 25th percentile. Healthcare utilization was self-reported, aggregated for one-year of follow-up and included: primary care consultations, medications, examinations, hospitalization, rehabilitation stay and operations. Costs were estimated based on unit costs collected from national pricelists. Nine potential modifiable prognostic factors were selected based on previous literature. Univariable and multivariable binary logistic regression models were used to identify and replicate associations (crude and adjusted for selected covariates) between each modifiable prognostic factor and high costs related to healthcare utilization.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Four modifiable prognostic factors associated with high costs related to healthcare utilization were identified and replicated: a higher degree of pain severity, disability, depression, and a lower degree of physical health-related quality of life. Kinesiophobia and recovery expectations showed no prognostic value. There were inconsistent results across the two cohorts with regards to comorbidity, radiating pain below the knee and mental health-related quality of life.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>The factors identified in this study may be future targets for intervention with the potential to reduce high costs related to healthcare utilization among older back pain patients.</jats:p> </jats:sec><jats:sec> <jats:title>Trial registration</jats:title> <jats:p><jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://clinicaltrials.gov">ClinicalTrials.gov</jats:ext-link> NCT04261309, 07 February 2020. Retrospectively registered.</jats:p> </jats:sec>

Citation

Killingmo, R. M., Chiarotto, A., van der Windt, D. A., Storheim, K., Bierma-Zeinstra, S. M. A., Småstuen, M. C., …Grotle, M. (2022). Modifiable prognostic factors of high costs related to healthcare utilization among older people seeking primary care due to back pain: an identification and replication study. BMC Health Services Research, 22(1), Article ARTN 793. https://doi.org/10.1186/s12913-022-08180-2

Journal Article Type Article
Acceptance Date Jun 13, 2022
Publication Date Jun 18, 2022
Journal BMC Health Services Research
Publisher Springer Verlag
Volume 22
Issue 1
Article Number ARTN 793
DOI https://doi.org/10.1186/s12913-022-08180-2
Keywords back pain; Healthcare utilization; costs; prognostic factor research
Publisher URL https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08180-2