A cost-of-illness study of back pain in The Netherlands

In this study we estimated the costs of back pain to society in The Netherlands in 1991 to be 1. 7% of the GNP. The results also show that musculoskeletal diseases are the fifth most expensive disease category regarding hospital care, and the most expensive regarding work absenteeism and disablement. One-third of the hospital care costs and one-half of the costs of absenteeism and disablement due to musculoskeletal disease were due to back pain. The total direct medical costs of back pain were estimated at US367. 6 million. The total costs of hospital care due to back pain constituted the largest part of the direct medical costs and were estimated at US200 million. The mean costs of hospital care for back pain per case were US3856 for an inpatient and US199 for an outpatient. The total indirect costs of back pain for the entire labour force in The Netherlands in 1991 were estimated at US4. 6 billion; US3. 1 billion was due to absenteeism and US1. 5 billion to disablement. The mean costs per case of absenteeism and disablement due to back pain were US4622 and US9493, respectively. The indirect costs constituted 93% of the total costs of back pain, the direct medical costs contributed only 7%. It is therefore concluded that back pain is not only a major medical problem but also a major economical problem.