Rehabilitation costs and subsequent costs in patients with chronic low back pain -: A cost of illness analysis of the functional restoration program of the clinic of rheumatology and rehabilitation of the locomotor system, rehabilitation center clinic Valens, Switzerland

Background: Health costs increase rapidly in Switzerland. Chronic low back pain contributes to a large portion to this cost developement. This study analyses the direct and indirect costs of patients with chronic low back pain participating in an in-patient function oriented training program. Method: From 145 patients, who participated in this rehabilitation program in 1999 and 2000, the costs of the in-patient rehabilitation, the medical costs and indirect costs were analyzed until 12 months after hospital discharge. The costs for the medical treatments were calculated according to the specialty list of the Federal Office of Health and with the drug compendium of Switzerland. Indirect costs were estimated according the human capital approach based on the work inability after the rehabilitation program. Comparative calculations according to sex, pain localisation, age and the rehabilitation potential of each patient (judged according the predictive factors from Kool and Oesch) have been carried out in addition. Results: The costs of in-patient rehabilitation and the costs of the out-patient treatments of 134 patients and the indirect costs of 133 persons could be analysed. Total direct costs amounted to 7802 Euro/person. The in-patient rehabilitation caused the greatest cost share, followed by the costs for the out-patient physiotherapies, the GP costs and drug costs. There were no statistically significant differences between sex, age, and pain localisation. Patients with no rehabilitation potential generated significantly higher direct medical costs in the out-patient setting than patients with a good rehabilitation potential. Patients with a good rehabilitation potential caused lower indirect costs (21% less) than patients with no rehabilitation potential (statistically significant). Conclusions: With regard to the direct medical costs there were no statistically significant differences regarding sex, age and pain localisation. On the other hand, patients with no rehabilitation potential generated higher direct and indirect costs than patients with a good rehabilitation potential.