ArticleBMJ open2012
How does comorbidity influence healthcare costs? A population-based cross-sectional study of depression, back pain and osteoarthritis.
Article in BMJ open, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Costs of multimorbidity: a systematic review and meta-analyses.BMC medicine · 2022Pooled it
- Pooled it
- The excess costs of depression: a systematic review and meta-analysis.Epidemiology and psychiatric sciences · 2019Pooled it
- Article
- Initial-Care Medical and Prescription Costs for Incident Metastatic versus Nonmetastatic Colorectal Cancer.Cancer research communications · 2025Article
- Association between depression and health care expenditure in middle-aged and older patients with heart disease.PloS one · 2025Article
- The Problem of Pain in Lupus: Epidemiological Profiles of Patients Attending Multidisciplinary Pain Clinics.Pain management nursing : official journal of the American Society of Pain Management Nurses · 2024Article
- Multimorbidity healthcare expenditure in Belgium: a 4-year analysis (COMORB study).Health research policy and systems · 2024Article
- Chronic Low Back Pain with and without Concomitant Osteoarthritis: A Retrospective, Longitudinal Cohort Study of Patients in England.International journal of clinical practice · 2023Observational
- Long-term sick leave for back pain, exposure to physical workload and psychosocial factors at work, and risk of disability and early-age retirement among aged Swedish workers.International archives of occupational and environmental health · 2022Article
- The Excess Costs of Depression and the Influence of Sociodemographic and Socioeconomic Factors: Results from the German Health Interview and Examination Survey for Adults (DEGS).PharmacoEconomics · 2021Article
- Depression Subtypes in Individuals With or at Risk for Symptomatic Knee Osteoarthritis.Arthritis care & research · 2020Observational
- The Influence of Life Experiences on the Development of Resilience in Older People With Co-morbid Health Problems.Frontiers in medicine · 2020Article
- The burden of chronic diseases among Australian cancer patients: Evidence from a longitudinal exploration, 2007-2017.PloS one · 2020Article
- Developing a comorbidity index for comparing cancer outcomes in Aboriginal and non-Aboriginal Australians.BMC health services research · 2018Article
- Article
- Sick leave in Sweden before and after total joint replacement in hip and knee osteoarthritis patients.Acta orthopaedica · 2017Observational
- Identifying Specific Combinations of Multimorbidity that Contribute to Health Care Resource Utilization: An Analytic Approach.Medical care · 2017Article
- Health care utilisation in subjects with osteoarthritis, chronic back pain and osteoporosis aged 65 years and more: mediating effects of limitations in activities of daily living, pain intensity and mental diseases.Wiener medizinische Wochenschrift (1946) · 2014Article
- Health care costs before and after diagnosis of depression in patients with unexplained pain: a retrospective cohort study using the United Kingdom General Practice Research Database.ClinicoEconomics and outcomes research : CEOR · 2013Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo analyse how comorbidity among patients with back pain, depression and osteoarthritis influences healthcare costs per patient. A special focus was made on the distribution of costs for primary healthcare compared with specialist care, hospital care and drugs.
designPopulation-based cross-sectional study.
settingThe County of Östergötland, Sweden. PATIENTS: Data on diagnoses and healthcare costs for all 266 354 individuals between 20 and 75 years of age, who were residents of the County of Östergötland, Sweden, in the year 2006, were extracted from the local healthcare register and the national register of drug prescriptions.
main outcome measuresThe effects of comorbidity on healthcare costs were estimated as interactions in regression models that also included age, sex, number of other health conditions and education.
resultsThe largest diagnosed group was back pain (11 178 patients) followed by depression (7412 patients) and osteoarthritis (5174 patients). The largest comorbidity subgroup was the combination of back pain and depression (772 patients), followed by the combination of back pain and osteoarthritis (527 patients) and the combination of depression and osteoarthritis (206 patients). For patients having both a depression diagnosis and a back pain diagnosis, there was a significant negative interaction effect on total healthcare costs. The average healthcare costs among patients with depression and back pain was SEK 11 806 lower for a patient with both diagnoses. In this comorbidity group, there were tendencies of a positive interaction for general practitioner visits and negative interactions for all other visits and hospital days. Small or no interactions at all were seen between depression diagnoses and osteoarthritis diagnoses.
conclusionsA small increase in primary healthcare visits in comorbid back pain and depression patients was accompanied with a substantial reduction in total healthcare costs and in hospital costs. Our results can be of value in analysing the cost effects of comorbidity and how the coordination of primary and secondary care may have an impact on healthcare costs.
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