573: ABSENTEEISM COSTS OF PATIENTS WITH LOW BACK PAIN SEEKING CARE AT EMERGENCY DEPARTMENTS

Topic: Education, Societal Impact, and Others
Subtopic: Economics

Background and Aims: Patients with low back pain (LBP) often seek emergency care1, although this health condition should primarily be managed in primary care settings. Patients believe their symptoms are related to serious pathologies2. LBP is the leading cause of disability worldwide3, affecting a large portion of the population, increasing the consumption of health services, and absenteeism costs. However, the evidence on absenteeism of patients with LBP seeking care in emergency departments remains underexplored. This study aims to estimate the absenteeism costs associated with LBP and identify factors associated with these costs among patients with LBP seeking care in emergency departments.

Methods: This is a cost-of illness study using data from a prospective inception cohort study, conducted from the societal perspective with time horizon of 12 months. Six hundred patients with recent-onset non-specific LBP, aged >18 years, both sexes, and who sought care in four emergency departments in São Paulo, Brazil, were included. Absenteeism days were measured using a questionnaire to estimate the absenteeism costs using human capital approach. The absenteeism costs were analysed descriptively and reported for overall sample, acute and chronic LBP separately. Multiple linear regression analyses were used to identify sociodemographic and clinical factors associated with the absenteeism costs.

Results: The mean absenteeism duration was 158 days per patient, representing US$7,921 absenteeism costs per patient. Patients with chronic LBP had a longer absenteeism duration (175 days) and higher costs (US$ 8,704) compared to the patients with acute LBP (145 days and US$7,337). Overall, factors associated with higher absenteeism costs were presence of leg pain, depressive symptoms, and being divorced compared with singles. However, female, high educational level, and high levels of disability were associated with lower costs.

Conclusions: This study estimates the economic burden of LBP-related absenteeism among patients with non-specific LBP seeking care in emergency department from Brazil. Patients with chronic LBP showed higher absenteeism costs. Sex, marital status, educational level, smoker, leg pain, tension and anxiety, feeling depressive, and disability were factors associated with absenteeism costs. Identifying factors associated with absenteeism costs may help inform public health policies for early intervention strategies for patients with LBP to reduce productivity losses. Identifying clinical and sociodemographic factors associated with absenteeism can help clinicians and decision makers adopt appropriate initiatives to help improve patients' clinical outcomes and reduce costs.

References: 1. Ferreira, et al. Low back pain presentations to New South Wales emergency departments: trends over time and geographical variation. Emerg Med Australas. 2021;33(5):868–74.
2. Oshima, et al. Why do patients with low back pain seek care at emergency department? A cross-sectional study. Braz J Phys Ther. 2022;26(5):100444.
3. GBD 2019 Diseases and Injuries Collaborators. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204–22.

Presenting Author: Mariana Viera Volpi
Submitting Author: Gisela Cristiane Miyamoto

Senior Author: Gisela Cristiane Miyamoto

IASP 2026 Global Year theme of Neuropathic Pain: No

• Luiz Felício Cadete Scola: PhD - Universidade Cidade de São Paulo, Centro de Estudos e Pesquisa Instituto Wilson Mello, and Universidade Paulista
• Indiara Soares Oliveira: PhD - Universidade Cidade de São Paulo
• Lucíola da Cunha Menezes: PhD - Instituto de Prática Baseada em Evidências