Predictors of high-cost patients with acute whiplash-associated disorder in Japan.

Autor: Hayashi K; Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, United States of America.; Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan., Miki K; Center for Pain Management, Hayaishi Hospital, Osaka, Japan.; Faculty of Health Science, Osaka Yukioka College of Health Science, Ibaraki, Japan.; Department Rheumatology, Yukioka Hospital, Osaka, Japan.; Japan Pain Foundation, Tokyo, Japan., Ikemoto T; Department of Orthopedic Surgery, Aichi Medical University, Nagakute, Japan., Ushida T; Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan.; Japan Pain Foundation, Tokyo, Japan.; Institute of Physical Fitness, Sports Medicine and Rehabilitation, Aichi Medical University, Nagakute, Japan., Shiro Y; Japan Pain Foundation, Tokyo, Japan.; Department of Pain Medicine, Aichi Medical University, Nagakute, Japan.; Department of Physical Therapy, Faculty of Rehabilitation Sciences, Nagoya Gakuin University, Nagoya, Japan., Tetsunaga T; Japan Pain Foundation, Tokyo, Japan.; Department of Orthopaedic Surgery, Okayama University, Okayama, Japan., Takasusuki T; Japan Pain Foundation, Tokyo, Japan.; Department of Anesthesiology, Dokkyo Medical University, Mibu, Japan., Hosoi M; Japan Pain Foundation, Tokyo, Japan.; Department of Psychosomatic Medicine and Multidisciplinary Pain Center, Kyushu University Hospital, Fukuoka, Japan., Yukioka M; Faculty of Health Science, Osaka Yukioka College of Health Science, Ibaraki, Japan.; Department Rheumatology, Yukioka Hospital, Osaka, Japan.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Jun 28; Vol. 18 (6), pp. e0287676. Date of Electronic Publication: 2023 Jun 28 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0287676
Abstrakt: Introduction: The proportion of neck injuries due to traffic accidents is increasing. Little is known about high-cost patients with acute whiplash-associated disorder (WAD). The present study aimed to investigate whether time to first visit for conventional medicine, multiple doctor visits, or alternative medicine could predict high-cost patients with acute WAD in Japan.
Methods: Data from a compulsory, no-fault, government automobile liability insurance agency in Japan between 2014 and 2019 were used. The primary economic outcome was the total cost of healthcare per person. Treatment-related variables were assessed based on the time to first visit for conventional and alternative medicine, multiple doctor visits, and visits for alternative medicine. Patients were categorized according to total healthcare cost (low, medium, and high cost). The variables were subjected to univariate and multivariate analysis to compare high-cost and low-cost patients.
Results: A total of 104,911 participants with a median age of 42 years were analyzed. The median total healthcare cost per person was 67,366 yen. The cost for consecutive medicine, for consecutive and alternative medicine, and total healthcare costs were significantly associated with all clinical outcomes. Female sex, being a homemaker, a history of WAD claim, residential area, patient responsibility in a traffic accident, multiple doctor visits, and visits for alternative medicine were identified as independent predictive factors for a high cost in multivariate analysis. Multiple doctor visits and visits for alternative medicine showed large differences between groups (odds ratios 2673 and 694, respectively). Patients with multiple doctor visits and visits for alternative medicine showed a significantly high total healthcare cost per person (292,346 yen) compared to those without (53,587 yen).
Conclusions: A high total healthcare cost is strongly associated with multiple doctor visits and visits for alternative medicine in patients with acute WAD in Japan.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Hayashi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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