Medical specialists care and hospital costs for low back pain in the Netherlands

C. J. Itz*, B. L. T. Ramaekers, M. van Kleef, C. D. Dirksen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: To examine the organization of medical specialist careand hospital costs for low back pain (LBP) in the Netherlands.
Methods: Aggregated health insurance claims data were provided on alldiagnosis treatment combination (DTC) declarations for LBP patients firstreferred to the hospital in the 2nd half of 2008 and retrieved from Vektis,an organization that collects health insurance claims data. Data wereavailable up to 1 January 2012. The data included patient characteristics,DTC-specific information including: neurology, neurosurgery, orthopaedicsurgery, anaesthesiology and radiology.
Results: In total 80,652 LBP patients were referred to the hospital forthe first time in the second half of 2008 accumulating to a total of173,620 DTC’s with total costs of €194 million. Of these patients, 56%were female and 61% aged above 50 years at first referral to thehospital. The average number of DTC’s and costs per patient were 2.15and €2410, respectively (during the follow-up period of 3.0–3.5 year).Moreover, 51% of the patients needed only one DTC; less than 10% ofpatients needed 5 DTC’s. Following the DTC number, the share ofconsultations to the neurologist decreased, whereas that of theanaesthesiology specialism increased. The largest portion of costs wasallocated to the anaesthesiology and neurosurgery specialisms.
Conclusions: In the Netherlands, LBP patients consult a variety ofmedical specialists, in particular, the neurology, hospital costs for LBPpatients are expected to increase given the rising incidence. Optimaldiagnosis and tailored treatment plans might result in reduced costs andimproved patient outcomes.
Significance: Low back pain patients consult various specialists, withthe majority first referred to the neurologist. More than half of the LBDpatients require only one DTC and less than 10% needed five DTC’s ormore. The largest portion of the hospital costs for LBP patients isallocated to the anaesthesiology and neurosurgery specialisms.
Original languageEnglish
Pages (from-to)705-715
Number of pages11
JournalEuropean Journal of Pain
Issue number4
Publication statusPublished - Apr 2017

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