Original Title: Impacto sanitario, económico y social del dolor lumbar en la Comunidad Autónoma del País Vasco

Authors' objectives: Determine the impact of low back pain on the health and quality of life of the population. Determine the methods used by professionals with regard to low back pain. Determine the extension of the problem in terms of the consumption of health resources directly attributed to this and the associated problem of absenteeism at work and ascertain the total cost deriving from this disorder in the Economist Community of the Basque Country.

Authors' results and conclusions: Thirty-three per cent of the controls suffered low back pain during the last year, which coincides with the estimated annual morbidity. The perception of current health is lower among patients with lumbago and scales of anxiety and depression are higher in patients with chronic pain, which is more frequent in sedentary jobs. The pattern of radicular pain becomes more chronic than the average and psychogenic pain cannot be alleviated with any treatment. Of the 2,067,158 inhabitants of the Autonomous Community of the Basque Country, 217,052 (10.5%), are assessed for low back pain by Primary Care services in one year. 11,162 (0.54%) are referred to specialists. 1,939 (0.09%) are admitted to a hospital in the Public Network and 1,043 are subjected to surgery (0.05%) (713 discectomies and 330 arthrodeses). The costs generated by different systems place the locomotor system immediately behind the respiratory tract; but although in the latter case, these costs consist basically pharmacy expenses, in the case of the locomotor system the costs are basically attributable to Temporary Incapacity (TI). Half of these cases of temporary incapacity are attributable to low back pain, which makes lumbago the primary individual cause of temporary incapacity. With regard to its duration, 90.77% of the total cases of temporary incapacity due to low back pain have consumed 47.39% of working days lost while the remaining 9.23% exceed 52% of the consumption of working days. Low back pain represents 20.08% of locomotor episodes, but when we talk about costs, the percentage represented by low back pain in this system rises to 31.39% and up to 38.04% if we refer only to Temporary Incapacity. In the private sector, the duration of TI due to accidents in the workplace, treated by mutual insurance companies, decreases to virtually half that figure. Both in public and private health, a small proportion of patients generate most of the expenses. These expenses are attributable basically to indirect costs (TI) with a total of 224,136,419 €. This represents 0.58% of the GDP of the Basque Country during the year 2000.

Authors' recommendations: There are few pathologies with the individual, social and economic importance of low back pain. It is influenced by psychological, social and work-related factors. It is a problem that tends to reoccur and its necessary to prevent it from becoming a chronic disorder. Most of the costs related with low back pain (consultations, medicine, additional tests, hospital admissions, surgery, incapacity) are due to the extension of the overall episode in a small proportion of patients. The doctors that treat these patients do not have the tools to deal with these problems, as is shown in the high variability of clinical practice. The implementation of a clinical classification system for low back pain could help to characterise patients and optimise the way in which this pathology is treated, although we must improve its precision. The coordination and integration of information between the different health care areas may contribute to reducing the duration of the episode.

Authors' methods: Bibliographical search. Stratified transversal study of a representative population by means of a survey of 264 patients with low back pain and 91 healthy controls. Survey of professionals. Analysis of a sample of 43,245 patients in three Health Centres belonging to each of the Basque provinces. The population pyramids of the three Centres are representative of the total population of the Basque Community. The data processed in the survey corresponds to 1999 and 2000 and in order to organise all the information this has been standardised at 10,000 inhabitants/year. Analysis of health service databases: Osakidetza (Basque Health Service), Osatek (RMN), etc. Study of temporary incapacity based on the aforementioned sample and the ITEMP databases of the Health Department of the Basque Government. Resources consumed in the private sector: Industrial medicine and mutual insurance company services.

Project Status: Completed

Year Published: 2003

URL for published report: https://www.euskadi.eus/contenidos/informacion/2003_osteba_publicacion/es_def/adjuntos/2003/d_03-03_impacto_dolor_lumbar.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: Basque Office for Health Technology Assessment, Health Department Basque Government (OSTEBA)