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[Incidence, resource use and costs associated with postherpetic neuralgia: a population-based retrospective study]
Antonio Sicras-Mainar1, Ruth Navarro-Artieda, Jordi Ibáñez-Nolla
1Direccion de Planificacion y Desarrollo Organizativo, Badalona, España. asicras@bsa.cat
Aim:
To determine the incidence rate, the treatment administered and the use of health resources and health, and their respective costs in patients with postherpetic neuralgia (PHN).
Patients And Methods:
We performed an observational design, made from retrospective review of patient records from six primary care centers and one hospital. All patients > 30 years consulting for PHN between 1/1/2007 and 31/12/2010 were included. Prepared two study groups according to presence / absence of PHN. Follow up was for one year.
Main Measures:
socio-demographic, treatment and co-morbidity. The cost model differed direct healthcare costs (primary care/specialist) and indirect (productivity).
Statistical Analysis:
logistic regression models and analysis of covariance (p < 0.05).
Results:
1506 patients were recruited, age: 61.2 years female: 59.2%. 15.1% (n = 228, 95% CI = 8.1-22.1%) had a PHN (incidence rate: 0.8/1,000 inhabitants/year; 95% CI = 0.7-0.9/1,000 population/year), and increased with age (≥ 65 years: 19.7%). The PHN was principally associated with: psychosis (OR = 3.9), dementia (OR = 2.3), depression (OR = 1.8) and age (OR = 1.1), p < 0.03. Drugs use was higher (5.3 vs. 3.3; p < 0.001). The cost in primary care was 63.1% and 24.7% indirect. Total cost €1827.1 vs. €457.5 (p = 0.003), respectively, due to higher labour productivity losses (€692.2 vs. €62.4) and health costs (€1135 vs. €395.1); p < 0.001. All cost components maintained these differences.
Conclusions:
PHN is a frequent complication. These patients have a significant economic burden. The cost increases with age.
