Healthcare expenditure and its predictors in a cohort of Australians living with sciatica
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ORIGINAL ARTICLE
Healthcare expenditure and its predictors in a cohort of Australians living with sciatica Alexander Chye1 · Chung‑Wei Christine Lin2,3 · Mark J. Hancock4 · Ian Harris5 · Jane Latimer2,3 · Christopher G. Maher2,3 · Andrew J. McLachlan6 · Stephanie Mathieson2,3 · Bart Koes7,8 · Richard O. Day9 · Laurent Billot1 · Stephen Jan1 · Blake Angell1 Received: 23 May 2020 / Revised: 3 September 2020 / Accepted: 12 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To estimate the healthcare resource utilisation of an Australian cohort of people with sciatica and explore individuallevel factors associated with expenditure. Methods Healthcare utilisation (services and medication) data from a randomised, double-blind, placebo-controlled trial of pregabalin in patients with sciatica (n = 185) were analysed to estimate healthcare expenditure of participants over 12 months. Associations between key baseline socio-economic, pain and quality of life characteristics and healthcare expenditure were examined using generalised linear imputation models. Results On average, participants accessed AUD$1,134 of healthcare over the year, predominantly made up of $114 of medication and $914 of health services, which included $418 of physiotherapy services. Participants randomised to receive pregabalin incurred higher expenditure ($1,263 compared to $1,001 for placebo), which was largely driven by pregabalin ($158) and greater health services ($107). Healthcare expenditure was significantly higher for participants prescribed pregabalin, earning greater than $1,700 per week ($88,400 per year) and reporting poorer quality of life (physical and mental). Conclusion Our results suggest inefficiency in the use of healthcare resources due to increased healthcare resource utilisation in people with sciatica treated with pregabalin, compared to placebo. Costs of treating sciatica varied based on individual quality of life and socio-economic characteristics. Keywords Sciatica · Healthcare expenditure · Pregabalin · Cost predictors · Healthcare utilisation
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00586-020-06605-2) contains supplementary material, which is available to authorized users. * Alexander Chye [email protected] 1
The George Institute for Global Health, University of New South Wales, Level 5, 1 King Street, Newtown, Sydney 2041, Australia
2
The Institute for Musculoskeletal Health, Sydney, Australia
3
Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
4
Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
Sciatica (lumbosacral radicular syndrome) is characterised by radiating posterolateral leg pain that may be accompanied by back pain, sensory loss, weakness or reflex abnormalities [1]. 5–10% of the 4 million Australians who experience low-back pain (LBP) annually are esti
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