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. 2011 Dec 21:12:287.
doi: 10.1186/1471-2474-12-287.

Avoidable costs of physical treatments for chronic back, neck and shoulder pain within the Spanish National Health Service: a cross-sectional study

Pedro Serrano-Aguilar  1 , Francisco M Kovacs, Jose M Cabrera-Hernández, Juan M Ramos-Goñi, Lidia García-Pérez
Affiliations

Avoidable costs of physical treatments for chronic back, neck and shoulder pain within the Spanish National Health Service: a cross-sectional study

Pedro Serrano-Aguilar et al. BMC Musculoskelet Disord. .

Abstract

Background: Back, neck and shoulder pain are the most common causes of occupational disability. They reduce health-related quality of life and have a significant economic impact. Many different forms of physical treatment are routinely used. The objective of this study was to estimate the cost of physical treatments which, despite the absence of evidence supporting their effectiveness, were used between 2004 and 2007 for chronic and non-specific neck pain (NP), back pain (BP) and shoulder pain (SP), within the Spanish National Health Service in the Canary Islands (SNHSCI).

Methods: Chronic patients referred from the SNHSCI to private physical therapy centres for NP, BP or SP, between 2004 and 2007, were identified. The cost of providing physical therapies to these patients was estimated. Systematic reviews (SRs) and clinical practice guidelines (CPGs) for NP, BP and SP available in the same period were searched for and rated according to the Oxman and AGREE criteria, respectively. Those rated positively for ≥70% of the criteria, were used to categorise physical therapies as Effective; Ineffective; Inconclusive; and Insufficiently Assessed. The main outcome was the cost of physical therapies included in each of these categories.

Results: 8,308 chronic cases of NP, 4,693 of BP and 5,035 of SP, were included in this study. Among prescribed treatments, 39.88% were considered Effective (physical exercise and manual therapy with mobilization); 23.06% Ineffective; 13.38% Inconclusive, and 23.66% Insufficiently Assessed. The total cost of treatments was € 5,107,720. Effective therapies accounted for € 2,069,932.

Conclusions: Sixty percent of the resources allocated by the SNHSCI to fund physical treatment for NP, BP and SP in private practices are spent on forms of treatment proven to be ineffective, or for which there is no evidence of effectiveness.

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Figures

Figure 1
Figure 1
Distribution of physical therapies administered according to the evidence of effectiveness and its corresponding costs to patients with chronic nonspecific NP, BP or SP in Spanish National Health Service. Legend: I: Proven ineffective, E: Proven effective, IE: Inconclusive evidence on effectiveness, IA: Insufficiently Assessed.
See this image and copyright information in PMC

References

    1. Andersson GBJ. In: The Adult Spine: Principles and Practice. 2. Frymoyer JW, editor. New York: Raven Press; 1997. The epidemiology of spinal disorders; pp. 93–141.
    1. Kvarnstrom S. Occurrence of musculoskeletal disorders in a manufacturing industry with special attention to occupational shoulders. Scand J Rehab Med. 1983;8(Suppl):1–114. - PubMed
    1. Cailliet R. Shoulder pain. 3. Philadelphia: F.A. Davis Co; 1991.
    1. Sáinz de Murieta E, Fernández Baraibar J, Pascual I, Mena A, Martínez-Zubiri A, Condón MJ. Occupational disability due to locomotor pathology in the Foral Community of Navarra. Epidemiological aspects. An Sist Sanit Navar. 2005;28(1):83–92. - PubMed
    1. Rajala U, Keinänen-Kiukaanniemi S, Uusimäki A, Kivelä SL. Musculoskeletal pain and depression in a middle-aged Finnish population. Pain. 1995;61(3):451–457. doi: 10.1016/0304-3959(94)00206-T. - DOI - PubMed

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