In countries with limited health care services or a national health care system, patients don’t always get treated. This is especially true when the problem isn’t life-threatening or there’s no risk of permanent damage. This type of health delivery plan may adversely affect chronic pain patients.
In this study researchers from Finland look at the cost-utility results of treatment for neck and back problems. Cost-utility is a good way to measure how effective treatment is based on the cost. Patients with neck or back pain having surgery for disc problems or spinal stenosis were included.
Patients filled out a survey with questions about 15 areas of health status. The questions were about moving, seeing, hearing, and sleeping. Eating, mental function, and sexual activity were also included. The survey was completed before and after the operation.
The goal was to measure the effectiveness of the surgery based on changes in health-related quality of life (HRQOL). Change in HRQOL was compared to the cost of the treatment. The authors also looked at change in HRQOL for patients who were treated within 60 days. This was compared to patients whose treatment was delayed more than 60 days.
Results showed an improvement in HRQOL for patients in both groups. The patients who had lumbar surgery had the best results. Patients reported their health improved in the areas of sleeping, daily activities, and pain or discomfort.
Mood (depression and distress) was also better. For those patients who answered the questions, sexual activity was also improved. In cases where the surgery was delayed, the cost per unit of improved quality was doubled.
The authors conclude that the cost-utility of surgery for neck and back pain caused by disc problems or stenosis is favorable. Delaying treatment decreases the cost-utility. This information may help health care planners made decisions about future services offered when care is limited or resources are scarce.