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Cost-effectiveness ...
Cost-effectiveness of lumbar fusion and nonsurgical treatment for chronic low back pain in the Swedish lumbar spine study : A multicenter, randomized, controlled trial from the Swedish Lumbar Spine Study Group
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- Fritzell, Peter (author)
- Department of Orthopedic Surgery, Falun Hospital, Falun, Sweden,The Swedish Lumbar Spine Study Group
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- Hägg, Olle, 1949 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för ortopedi,Institute of Surgical Sciences, Department of Orthopaedics,Department of Orthopedic Surgery, Sahlgrenska University Hospital, Göteborg, Sweden,The Swedish Lumbar Spine Study Group
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- Jonsson, Dick (author)
- Linköpings universitet,Medicinsk teknologiutvärdering,Hälsouniversitetet
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- Nordwall, Anders, 1942 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för ortopedi,Institute of Surgical Sciences, Department of Orthopaedics,Department of Orthopedic Surgery, Sahlgrenska University Hospital, Göteborg, Sweden,The Swedish Lumbar Spine Study Group
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- Andréen, O. (contributor)
- Umeaå,The Swedish Lumbar Spine Study Group,Malmö
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- Appelgren, G. (contributor)
- Halmstad,The Swedish Lumbar Spine Study Group
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- Berg, S. (contributor)
- Uppsala,The Swedish Lumbar Spine Study Group,Lund
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- B. Branth, B. (contributor)
- Stockholm,The Swedish Lumbar Spine Study Group
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- Cederlund, C. G. (contributor)
- Göteborg,The Swedish Lumbar Spine Study Group
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- Elkan, P. (contributor)
- Stockholm,The Swedish Lumbar Spine Study Group
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- Hedlund, R. (contributor)
- Stockholm,The Swedish Lumbar Spine Study Group
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- Kogler, H. (contributor)
- Örebro,The Swedish Lumbar Spine Study Group
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- Leufvén, C. (contributor)
- Eskilstuna,The Swedish Lumbar Spine Study Group
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- Németh, G. (contributor)
- Stockholm,The Swedish Lumbar Spine Study Group
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- Neumann, P. (contributor)
- Göteborg,The Swedish Lumbar Spine Study Group
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- Nilsson, M. (contributor)
- Stockholm,The Swedish Lumbar Spine Study Group
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- Nordenström, K. (contributor)
- Karlstad,The Swedish Lumbar Spine Study Group
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- Ohlin, A. (contributor)
- Malmö,The Swedish Lumbar Spine Study Group
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- Ordeberg, G. (contributor)
- Uppsala,The Swedish Lumbar Spine Study Group
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- Reigo, Tomas (contributor)
- Linköpings universitet,Ortopedi och idrottsmedicin,Hälsouniversitetet,The Swedish Lumbar Spine Study Group
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- Sahlstrand, T. (contributor)
- Helsingborg,The Swedish Lumbar Spine Study Group
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- Sandberg, R. (contributor)
- Karlstad,The Swedish Lumbar Spine Study Group
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- Skogland, L. (contributor)
- Oslo,The Swedish Lumbar Spine Study Group
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- Strömqvist, B. (contributor)
- Lund,The Swedish Lumbar Spine Study Group
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- Tropp, Hans (contributor)
- Östergötlands Läns Landsting,Ortopedkliniken Norrköping,The Swedish Lumbar Spine Study Group
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- Tullberg, T. (contributor)
- Stockholm,The Swedish Lumbar Spine Study Group,Sundsvall
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- Wikström, T. (contributor)
- Sundsvall,The Swedish Lumbar Spine Study Group
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- Willén, J. (contributor)
- Göteborg,The Swedish Lumbar Spine Study Group
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(creator_code:org_t)
- Lippincott Williams & Wilkins, 2004
- 2004
- English.
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In: Spine. - : Lippincott Williams & Wilkins. - 0362-2436 .- 1528-1159. ; 29:4, s. 421-434
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://gup.ub.gu.se...
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Abstract
Subject headings
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- Study Design. A cost-effectiveness study was performed from the societal and health care perspectives. Objective. To evaluate the costs-effectiveness of lumbar fusion for chronic low back pain (CLBP) during a 2-year follow-up. Summary of Background Data. A full economic evaluation comparing costs related to treatment effects in patients with CLBP is lacking. Patients and Methods. A total of 284 of 294 patients with CLBP for at least 2 years were randomized to either lumbar fusion or a nonsurgical control group. Costs for the health care sector ( direct costs), and costs associated with production losses ( indirect costs) were calculated. Societal total costs were identified as the sum of direct and indirect costs. Treatment effects were measured using patient global assessment of improvement, back pain ( VAS), functional disability (Owestry), and return to work. Results. The societal total cost per patient ( standard deviations) in the surgical group was significantly higher than in the nonsurgical group: Swedish kroner (SEK) 704,000 ( 254,000) vs. SEK 636,000 ( 208,000). The cost per patient for the health care sector was significantly higher for the surgical group, SEK 123,000 ( 60,100) vs. 65,200 ( 38,400) for the control group. All treatment effects were significantly better after surgery. The incremental cost-effectiveness ratio ( ICER), illustrating the extra cost per extra effect unit gained by using fusion instead of nonsurgical treatment, were for improvement: SEK 2,600 ( 600 - 5,900), for back pain: SEK 5,200 ( 1,100 - 11,500), for Oswestry: SEK 11,300 ( 1,200 - 48,000), and for return to work: SEK 4,100 ( 100 21,400). Conclusion. For both the society and the health care sectors, the 2-year costs for lumbar fusion was significantly higher compared with nonsurgical treatment but all treatment effects were significantly in favor of surgery. The probability of lumbar fusion being cost-effective increased with the value put on extra effect units gained by using surgery.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Neurosciences (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- chronic low back pain
- degenerative disc disease
- lumbar spinal fusion
- RCT
- prospective randomized controlled study
- cost-effectiveness analysis
- sensitivity analysis
- societal perspective
- health care perspective
- Adult
- Aged
- Chronic Disease/economics
- Cost-Benefit Analysis/statistics & numerical data
- Disability Evaluation
- Humans
- Low Back Pain/economics/*surgery
- Lumbar Vertebrae/*surgery
- Middle Aged
- Outcome and Process Assessment (Health Care)/*statistics & numerical data
- Pain Measurement/statistics & numerical data
- Sensitivity and Specificity
- Sick Leave/economics/statistics & numerical data
- Spinal Fusion/*economics
- Sweden
- Treatment Outcome
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
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Spine
(Search for host publication in LIBRIS)
To the university's database
- By the author/editor
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Fritzell, Peter
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Hägg, Olle, 1949
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Jonsson, Dick
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Nordwall, Anders ...
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Andréen, O.
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Appelgren, G.
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show more...
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Berg, S.
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B. Branth, B.
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Cederlund, C. G.
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Elkan, P.
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Hedlund, R.
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Kogler, H.
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Leufvén, C.
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Németh, G.
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Neumann, P.
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Nilsson, M.
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Nordenström, K.
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Ohlin, A.
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Ordeberg, G.
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Reigo, Tomas
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Sahlstrand, T.
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Sandberg, R.
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Skogland, L.
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Strömqvist, B.
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Tropp, Hans
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Tullberg, T.
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Wikström, T.
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Willén, J.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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and Neurosciences
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
- Articles in the publication
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Spine
- By the university
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Linköping University
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University of Gothenburg