Costs and consequences of chronic pain due to musculoskeletal disorders from a health system perspective in Chile
Open accessAbstract
BACKGROUND: Chronic pain is a prevalent and distressing condition caused by an unceasing pain lasting more than 3 months or a pain that persists beyond the normal healing time. There is evidence of inadequate management partly explained by the unawareness regarding the magnitude of the problem. OBJECTIVES: To estimate the annual expected costs and consequences of chronic pain caused by musculoskeletal diseases from the health system perspective in Chile. METHODS: A Markov cohort model was built to represent chronic pain and estimate expected costs and consequences over 1-year time horizon. Transition probabilities were obtained through expert elicitation. Consequences examined were: years lost to disability (YLD), depression, anxiety, and productivity losses. Direct health care costs were estimated using local sources. Probabilistic sensitivity analysis was performed to characterize second-order uncertainty. RESULTS: The annual expected cost due to musculoskeletal chronic pain was estimated in USD $1387.2 million, equivalent to 0.417% of the national GDP. Lower back pain and osteoarthritis of the knee explained the larger proportion of the total cost, 31.8% and 27.1%, respectively. Depression attributed to chronic pain is another important consequence accounting for USD $94 million (Bayesian credibility interval 95% $49.1-$156.26). Productivity losses were also important cost, although early retirement and presenteeism were not measured. Chronic pain causes 137,037 YLDs. CONCLUSION: Chronic pain is not only an important cause of disability but also responsible for high social and financial burden in Chile. Public health programs focused on managing chronic pain may decrease burden of disease and possibly reduce costs.
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There is evidence that if presenteeism is not managed well, the costs can be higher than those because of absenteeism.
“There is evidence that if presenteeism is not managed well, the costs can be higher than those because of absenteeism.44”
From Productivity outcomes from chronic pain management interventions in the working age population; a systematic review (2024) · cites this paper as [44]
The Discussion identifies presenteeism as reduced productivity among workers who continue attending their jobs and says it has costs for patients and society. It does not compare those costs with absenteeism or say that poor management makes them higher; presenteeism was not measured in this study. (LLM, conf=0.82)
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- Authors
- Vargas, C., Bilbeny, N., Balmaceda, C., Rodríguez, M. F., Zitko, P., Rojas, R., Eberhard, M. E., Ahumada, M., & Espinoza, M. A.
- Affiliations
- University of Technology Sydney (AU)
- Asociación Chilena para el Estudio del Dolor (ACHED), Santiago, Chile,
- Pontificia Universidad Católica de Chile (CL)
- Health Technology Assessment Unit, Center of Clinical Research, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Corresponding author
- Espinoza, Manuel Antonio
- Venue
- PAIN Reports
- Published
- 2018-09
- Volume
- 3
- Issue
- 5
- Pages
- e656
- ISSN
- 2471-2531 (ISSN-L)
- PMC
- PMC6181463
- OpenAlex
- W2895487804
- Cited by
- 57
- References
- 25
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 7 · 2023: 7 · 2022: 12 · 2021: 7 · 2020: 8 · 2019: 3
- FWCI
- 2.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PAIN Reports (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- UTS ePRESS (University of Technology Sydney) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- chronic pain, musculoskeletal disorders, economic burden of disease, health care costs, depression, anxiety, productivity loss, low back pain, knee osteoarthritis, Markov cohort model, Chile
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