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Costes del dolor neuropático según etiología en las Unidades del Dolor en España.

2007; Q106299148; Volume: 14; Issue: 6 Linguagem: Espanhol

2254-6189

Marí­a José Rodrí­guez, Antonio Ruiz,

Musculoskeletal pain and rehabilitation

espanolObjetivo: Realizar un registro etiologico y de costes de pacientes con Dolor Neuropatico (DN) en Unidades del Dolor (UD) en Espana. Metodos: Estudio transversal retrospectivo realizado entre abril y diciembre de 2004 en UDs. Se recogieron datos demograficos, tipo y causa del DN, origen de la derivacion y la utilizacion de recursos sanitarios (tratamientos, visitas medicas, hospitalizaciones, etc.), y se computaron los costes medicos directos en el ano 2004. Se utilizo estadistica descriptiva y modelos ANCOVA. Resultados: Se incluyeron 504 pacientes con DN de etiologia variada (44% radiculopatia, 21% neuralgias, 11% neuropatias, 7% atrapamientos, 5% SDRC, 4% dolor central), con una edad de 57,8±0,7 anos (Media±EE), 57,6% mujeres, y 29,6±2,2 meses de evolucion. El coste medio mensual ajustado fue de 403€ (IC 95%: 333€-473€). Las neuropatias presentaron un coste medio mensual ajustado mayor que la media (580+90€, p=0,011), debido a un mayor numero mensual de dias de hospitalizacion (0,6±0,1, p=0,021) y mayor coste farmacologico (162+17€, p=0,001). Las radiculopatias mostraron menor coste que la media; 287+46€, p=0,026, particularmente por un menor coste de hospitalizacion; 79+38€, p=0,027. Conclusiones: El DN ocasiona una considerable utilizacion de recursos sanitarios con un coste sustancial para el Sistema Nacional de Salud. La neuropatia es el sindrome etiologico que tiene un mayor coste mensual por paciente, mientras que las radiculopatias muestran un coste significativamente inferior al promedio. EnglishObjective: To realize a registry about aetology and costs of patients with Neuropathic Pain (NeP) in Pain Clinics (PC) in Spain. Methods: Retrospective, cross-ssectional study performed between april and december 2004 in PC. Demographic data, NeP type and cause, origin of the derivation, and health resources consumption (treatments, medical visits, hospitalizations, etc) were collected and direct medical costs were calculated in year 2004. A descriptive statistic and ANCOVA models were applied. Results: 504 NeP patients of broad aetiology (44% radiculophaty, 21% neuralgias, 11% neurophaties, 7% entrapment syndromes, 5% CRPS, 4% central pain), 57.8±0.7 years (Mean±SE), 57.6% women, and 29.6±2.2 months of evolution, were enrolled in the study. Adjusted monthly average cost was 403€ (95% CI: 333€-473€). Neuropathies present an adjusted monthly cost significantly higher than average (580+90€, p=0.011), because of the higher number of hospitalization days (0.6+0.1, p=0.021) and the higher pharmacologic cost (162+17€, p=0.001). Radiculophaties showed lower adjusted cost than the average; 287+46€, p=0.026, because of the lower cost of hospitalization; 79+38€, p=0.027. Conclusions: NeP causes a considerable utilization of health resources with a substantial cost for the National Health Service. Neurophaties are the aetiology syndrome which showed the higher monthly cost per patient, while radiculophaties showed a cost significantly lower than the average.