Cost-Effectiveness Analysis of Different Treatments in Lumbar HIVD Patients
Date Issued
2011
Date
2011
Author(s)
Lee, Kuei-Chen
Abstract
Purpose：
Herniation of intervertebral disc (HIVD) in lumbar spine is a common issue that makes patients painful and limits them in some of daily activities. Traditional rehabilitation programs can relieve the symptoms but those will take lots of time and money. One kind of invasive treatment”epidural steroid injection” has beter used in many countries, but not been broadly received in Taiwan. So I want to study whether this treatment can get faster effects and spend a reasonable cost than the traditional rehabilitation programs.
Methods :
The patients with the main diagnosis of lumbar HIVD with root compression were separated into two groups. The experimental group received epidural steroid injection and traditional rehabilitative treatments. The control group received rehabilitative treatments only. Two groups both received in-hospital treatments. We collected the data of pre-treatment, one week and one month after the treatments. The effective indicators included decrease of back pain, decrease of leg pain, Oswestry Disability Index(ODI),and depressive scores. Then we compare the effect of two treatments, therapeutic cost, medicine cost and injection fee for cost-effectiveness analysis.
Outcomes:
The study group and control group had obvious improvement after the treatment one week and one month later . No significant difference was observed only in the depressive scores of the control group . The results indicated that both treatments are effective. Then we compare the differences between the two groups. The outcomes showed that the study group were better than the control group, especially in the decrease of LBP and ODI . In the analysis of ICER(ΔC/ΔE),the study group had better CEA. than the control group despite the experimental group had higher cost.
Conclusion :
The treatment of epidural steroid injection for HIVD patients is not popular in Taiwan and is costly . Based on the short-term effectiveness in our study, we can still have a conclusion that traditional rehabilitation programs combining this positive procedure can obviously relieve the back pain and improve the daily activities.
Subjects
herniated intervertebral disc
epidural steroid injection
cost-effectiveness analysis
Type
thesis
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