European Spine Journal

, Volume 14, Issue 4, pp 337–345 | Cite as

The costs for persons sick-listed more than one month because of low back or neck problems. A two-year prospective study of Swedish patients

  • Elisabeth K. Hansson
  • Tommy H. Hansson
Original Article


The total costs for patients who are sick-listed due to back and neck problems have not previously been determined prospectively on an individual basis. This study aimed to determine the total cost to a society, based on individually assessed costs of health services and loss of production in people who are sick-listed 28 days or more for back or neck problems. Detailed data on individuals’ health-care consumption due to back or neck problems was collected through prospectively entered diaries and questionnaires, after 4 weeks, 3 months, 1 and 2 years, in a consecutively selected cohort of 1,822 employed persons aged between 18 and 59 years. Costs for health care and production losses due to work absenteeism were determined individually and combined to render total costs to society. The costs for all medical services during the 2-year study were 6.9% of total costs for back and neck problems. The single most expensive medical service was surgery. Transferred to a national level, annual total costs for back and neck problems corresponded to 1% of GNP. In conclusion, direct health-service costs were a small fraction of the total costs, consequently indirect costs offer the greatest potential for savings.


Back pain Neck pain Cost of illness Disability Sick-listing 



This study was supported by grants from The Medical Faculty, Göteborg University and the Swedish Council for Social Research. We are greatly indebted to Professor Ed Palmer at the Evaluation Department, National Social Insurance Board for his invaluable cooperation, to Associate Professor Robert Jonsson for statistical advice and Professor Alf Nachemson for his great support.


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Department of Orthopaedics, Institute of Surgical SciencesSahlgrenska Academy, Göteborg UniversityGöteborgSweden
  2. 2.Department of OrthopaedicsSahlgrenska University HospitalGöteborgSweden

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