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Rehabilitation benefits highly motivated patients: a six-year prospective cost-effectiveness study

Grahn, Birgitta E M; Borgquist, Lars A and Ekdahl, Charlotte LU (2004) In International Journal of Technology Assessment in Health Care 20(2). p.214-221
Abstract
Objectives:To compare the six-year outcome of a multidisciplinary rehabilitation program with continued care within primary care in terms of health-related quality of life and cost-effectiveness. Furthermore, predictors of total costs to society were examined.



Methods:A prospective, matched, controlled, six-year follow-up was designed. The study included 236 patients (42 men, 194 women) nineteen to sixty-one years of age with prolonged musculoskeletal disorders. The intervention comprised a four-week multidisciplinary rehabilitation and an active one-year follow-up based on a bio-psycho-social approach. The control group received continued care within primary care. The main outcome measures were quality of life measured... (More)
Objectives:To compare the six-year outcome of a multidisciplinary rehabilitation program with continued care within primary care in terms of health-related quality of life and cost-effectiveness. Furthermore, predictors of total costs to society were examined.



Methods:A prospective, matched, controlled, six-year follow-up was designed. The study included 236 patients (42 men, 194 women) nineteen to sixty-one years of age with prolonged musculoskeletal disorders. The intervention comprised a four-week multidisciplinary rehabilitation and an active one-year follow-up based on a bio-psycho-social approach. The control group received continued care within primary care. The main outcome measures were quality of life measured using the Nottingham Health Profile, motivation identified by an interview and patient-specific total costs to society. Differences in mean costs between groups and cost-effectiveness were evaluated by applying nonparametric bootstrapping techniques.



Results: Total costs per treated patient in the rehabilitation group and the control group were £43,464 (SD=31,093) and £44,123 (SD=33,333), respectively (p=.896). Multidisciplinary rehabilitation improved quality of life somewhat more cost-effectively. Motivation was revealed as a predictor of total costs.



Conclusion: In the long-run, the evaluated multidisciplinary rehabilitation improved the highly motivated patients' quality of life most cost-effectively. The latently motivated patients may require rehabilitation, which is less intensive and with a longer duration, to improve their health in a whole-person perspective. The burden of prolonged musculoskeletal disorders to society was reaffirmed. Motivation could be a predictor of total costs, a factor which has to be taken into account in the examination procedure. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Journal of Technology Assessment in Health Care
volume
20
issue
2
pages
214 - 221
publisher
Cambridge
external identifiers
  • pmid:15209181
  • wos:000221724800012
  • scopus:2542459494
ISSN
1471-6348
DOI
10.1017/S0266462304000996
language
English
LU publication?
yes
id
7b186cf6-de33-4bfc-bb48-110201b9c0e5 (old id 124028)
date added to LUP
2007-07-24 09:52:24
date last changed
2017-07-23 03:44:26
@article{7b186cf6-de33-4bfc-bb48-110201b9c0e5,
  abstract     = {Objectives:To compare the six-year outcome of a multidisciplinary rehabilitation program with continued care within primary care in terms of health-related quality of life and cost-effectiveness. Furthermore, predictors of total costs to society were examined.<br/><br>
<br/><br>
Methods:A prospective, matched, controlled, six-year follow-up was designed. The study included 236 patients (42 men, 194 women) nineteen to sixty-one years of age with prolonged musculoskeletal disorders. The intervention comprised a four-week multidisciplinary rehabilitation and an active one-year follow-up based on a bio-psycho-social approach. The control group received continued care within primary care. The main outcome measures were quality of life measured using the Nottingham Health Profile, motivation identified by an interview and patient-specific total costs to society. Differences in mean costs between groups and cost-effectiveness were evaluated by applying nonparametric bootstrapping techniques.<br/><br>
<br/><br>
Results: Total costs per treated patient in the rehabilitation group and the control group were £43,464 (SD=31,093) and £44,123 (SD=33,333), respectively (p=.896). Multidisciplinary rehabilitation improved quality of life somewhat more cost-effectively. Motivation was revealed as a predictor of total costs.<br/><br>
<br/><br>
Conclusion: In the long-run, the evaluated multidisciplinary rehabilitation improved the highly motivated patients' quality of life most cost-effectively. The latently motivated patients may require rehabilitation, which is less intensive and with a longer duration, to improve their health in a whole-person perspective. The burden of prolonged musculoskeletal disorders to society was reaffirmed. Motivation could be a predictor of total costs, a factor which has to be taken into account in the examination procedure.},
  author       = {Grahn, Birgitta E M and Borgquist, Lars A and Ekdahl, Charlotte},
  issn         = {1471-6348},
  language     = {eng},
  number       = {2},
  pages        = {214--221},
  publisher    = {Cambridge},
  series       = {International Journal of Technology Assessment in Health Care},
  title        = {Rehabilitation benefits highly motivated patients: a six-year prospective cost-effectiveness study},
  url          = {http://dx.doi.org/10.1017/S0266462304000996},
  volume       = {20},
  year         = {2004},
}