A Review of Economic Factors Related to the Delivery of Health Care for Chronic Low Back Pain

作者：North Richard B^*; Shipley Jane; Wang Haibin; Mekhail Nagy

来源：Neuromodulation, 2014, 17: 69-76.

DOI：10.1111/ner.12057

• chronic low back pain
• cost-effectiveness
• economic factors
• failed back surgery syndrome
• review

Introduction and Methods: We describe tools used to evaluate the economic impact of health care interventions, discuss the economic burden of chronic low back pain, and review evidence on the cost-effectiveness of treating failed back surgery syndrome with spinal cord stimulation, intrathecal drug delivery, acupuncture, epidural injections, disc prosthesis, lumbar fusion, and noninvasive therapies. We also mention the lack of cost studies for emerging therapies, such as vibrotherapy and peripheral nerve field stimulation. Topics include types of cost studies; the economic perspectives taken by such studies; direct and indirect costs; measures of success; definitions of cost-effectiveness, incremental cost-effectiveness, incremental cost-utility ratios, and quality-adjusted life years; the concept of maximum willingness to pay; and the use of cost-effectiveness models.
Conclusion: The fact that chronic low back pain arises from a variety of causes makes choosing appropriate treatment difficult. Determining the cost-effectiveness of various treatments for chronic low back pain depends on well-designed and well-executed randomized controlled trials with parallel economic evaluations. Researchers can use economic models to extrapolate costs and outcomes over the long term.

• 出版日期2014-10