Journal of Rehabilitation Medicine 51-1CompleteIssue | Page 69
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G. Müller et al.
Table VI. Mean direct and indirect medical costs per year by treatment group, in EUR
Direct medical costs
Total costs within two years pre intervention
1 st year post intervention
2 nd year post intervention
Total costs within two years post intervention
Direct back pain medical costs
Total costs within two years pre intervention
1 st year post intervention
2 nd year post intervention
Total costs within two years post intervention
Indirect medical costs
Total costs within two years pre intervention
BE ST BE–ST
Mean (SD) Mean (SD) Difference %
95% CI
–4 [–692; 437]
p
3,215 (5,998) 3,343 (4,329) –128 2,173 (3,355) 2,446 (4,906) –272 –11 [–644; 99] 0.151
1,799 (3,554)
3,972 (6,155) 2,289 (6,322)
4,735 (9,783) –491
–763 –21 [–917; –64]
–16 [–1,467; –59] 0.024
0.034
7
1
0.658
571 (1,686) 564 (1,424) [–156; 169] 0.935
242 (1,056) 471 (252) –228 –49 [–377; –80] 0.003
242 (1,233)
485 (1,709)
253 (1,839)
723 (3,248) –10
–239 –4 [–148; 127]
–33 [–451; –27] 0.883
0.027
–5 [–666; 398] 0.620
2,711 (5,362) 2,845 (5,323) –134 2 nd year post intervention
Total costs within two years post intervention 1,368 (3,634) 2,563 (7,767) –119 –47 [–1,673; –716] < 0.001
1,286 (3,718)
2,654 (5,637) 1,574 (4,009)
4,137 (9,032) –288
–148 –18 [–664; 87]
0.132
–36 [–2,129; –836] < 0.001
Indirect back pain medical costs
Total costs within two years pre intervention 895 (276) 967 (3,798) 72 434 (2,303) 787 (4,721) –353 –45 [–650; –56]
0.020
378 (2,788)
812 (3,737) 365 (2,516)
1,152 (5,455) 13
–340 4 [–259; 284]
–30 [–754; 73]
0.926
0.107
1 st year post intervention
1 st year post intervention
2 nd year post intervention
Total costs within two years post intervention
7
[–371; 228]
0.639
SD: standard deviation; CI: confidence interval; BE: back exercise; ST: standard treatment.
Table VII. Difference in direct medical costs (total costs within two
years post intervention) of back exercise and standard treatment
Cost areas Difference % 95% CI
Drugs
Therapeutics
Outpatient
Hospital
Sick pay
Rehabilitation
Back exercise
Total –207
–36
–66
–463
–431
–28
467
–763 –22
–16
–5
–36
–53
–29
97
–16 [–480; 66]
0.318
[–75; 3]
0.069
[–177; 57]
0.248
[–855; –71]
0.021
[–693; –169]
0.001
[–74; 18]
0.235
[443; 492]
< 0.001
[–1,467; –59]
0.034
effects are realized simultaneously with cost savings.
Exercising is cost-effective (p < 0.05) at a maximum
willingness to pay of 4,370 EUR at grade 3 GCPS,
7,500 EUR at grade 2, and 19,300 EUR at grade 1
(Table XI). MWTP values for the individual GCPS
grades were determined by iterations.
p
CI: confidence interval.
Table VIII. Back pain and functional impairments during the last 6 months (pre intervention = t0, 1 st year post intervention = t2, 2 nd
year post intervention = t4)
BE ST BE-ST Mean (SD) Mean (SD) Difference 6.9 (2.0) 6.4 (2.4) 2 nd year post intervention 4.8 (2.4) 5.7 (2.6) –0.9 –15.9 [–1.2; –0.6] < 0.001
4.5 (2.4) 5.5 (2.6) –1.0 –17.8 [–1.3; –0.6] < 0.001
Mean back pain
Within six months pre 5.1 (2.0) 4.9 (2.3) 2 nd year post intervention 3.4 (2.0) 4.4 (2.4) –1.0 –23.3 [–1.3; –0.8] < 0.001
3.2 (2.1) 4.1 (2.3) –0.9 –21.8 [–1.2; –0.6] < 0.001
Impairment of daily activities
Within six months pre intervention 3.8 (2.3) 3.7 (2.6) 2.3 (2.2) 3.3 (2.6) –1.0 –30.5 [–1.3; –0.7] < 0.001
2.2 (2.2) 3.0 (2.5) –0.8 –27.1 [–1.1; –0.5] < 0.001
Severest back pain
Within six months pre intervention
1 st year post intervention
1 st year post intervention
1 st year post intervention
2 nd year post intervention
Days with pain
Within six months pre intervention
0.1
0.1
95% CI
8.6 [0.3; 0.8]
2.7 [–0.10.3]
3.0 [–0.1; 0.3]
< 0.001
0.197
0.358
86.7 (62.6) 87.6 (67.5) –0.9 52.5 (60.7) 75.0 (67.3) –22.5 –30.0 [–30.7; –14.3] < 0.001
2 nd year post intervention 48.9 (57.7) 68.3 (64.7) –19.4 –28.4 [–27.5; –11.3] < 0.001
2.2 (1.0) 2.2 (1.1) 1.5 (0.9) 2.1 (1.2) –0.5 –26.0 [–0.7; –0.4]
< 0.001
1.5 (0.9) 1.9 (1.1) –0.4 –20.0 [–0.5; –0.2]
< 0.001
1 st year post intervention
2 nd year post intervention
SD: standard deviation; BE: back exercise; ST: standard treatment.
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0.0
–1.1 [–7.3; 5.4]
p
1 st year post intervention
Graded Chronic Pain Status
Within six months pre intervention
0.5
%
0.9 [–0.1; 0.1]
0.775
0.722