Low back pain should be considered a health and research priority in Brazil: Lost productivity and healthcare costs between 2012 to 2016

• Published in: PloS one 2020-04, Vol.15 (4), p.e0230902-e0230902
• Main Authors: Carregaro, Rodrigo Luiz, Tottoli, Caroline Ribeiro, Rodrigues, Daniela da Silva, Bosmans, Judith E, da Silva, Everton Nunes, van Tulder, Maurits
• Format: Article
• Language: English
• Subjects: Absenteeism; Absenteeism (Labor); Back pain; Chronic illnesses; Clinical decision making; Cost benefit analysis; Costs; Decision making; Diagnostic imaging; Diagnostic systems; Disabilities; Disability; Diseases; Economic analysis; Economic aspects; Economic conditions; Health care; Health care costs; Health sciences; Hospitals; Illnesses; Information systems; Intensive care; Labor productivity; Low back pain; Medical diagnosis; Medical economics; Medical research; Medicine and Health Sciences; Occupational therapy; Orthoses; Pain; People and places; Physical therapy; Population; Production management; Productivity; Professional activities; Professional services; Prostheses; Prosthetics; Rehabilitation; Research and Analysis Methods; Retirement; Social aspects; Social Sciences; Social security; Socioeconomic factors; Studies; Workers
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0230902

Low Back Pain (LBP) is associated with an increase in disability-adjusted life years, and increased risk of disability retirement and greater absenteeism in Brazil. Hence, evidence on healthcare and lost productivity costs due to LBP is of utmost importance to inform decision-makers. Cost-of-illness study with top-down approach, and societal perspective. We extracted data from National databases, considering the period 2012-2016. Outpatient expenses included clinical, surgical, diagnosis, orthosis/prosthetics, and complementary actions. Inpatient care expenses included hospital and professional services, intensive care unit, and companion stay. For productivity losses, duration of work absence and associated information (work-related and non-work-related; value of the sickness absence benefit; age; gender; and economic activity) were analyzed. Lost productivity costs were calculated multiplying the absence from work (days) by the daily-benefit. The societal costs amounted to US$ 2.2 billion, and productivity losses represented 79% of the costs. Total healthcare expenses were estimated to US$ 460 million. We found more than 880,000 diagnostic images. Individuals with LBP were in total 59 million days absent from work between 2012-2016. The mean lost days absent from work per person, for each year investigated was, respectively, 88; 84; 83; 87; and 100. Men were more days absent from work than women. In addition, rural workers presented greater absence from work compared to other professional activities. Healthcare expenses and lost productivity costs due to LBP were substantial, hence, there is a need for improvement of health services and policies to deal with this increasing burden of illness. We found an extensive use of diagnostic imaging, which is rather discouraged by clinical guidelines. We assume that men were experiencing high levels of back pain disability compared with women, as they presented greater absenteeism and higher lost productivity costs.