Economic and Health-Related Quality of Life Outcomes of Whiplash Associated Disorders. Issue 17 (September 2016)

• Record Type: Journal Article
• Authors: Pink, Joshua; Petrou, Stavros; Williamson, Esther; Williams, Mark; Lamb, Sarah E.
• Is Part Of: Spine. Volume 41:Issue 17(2016)
• Publication Date: 2016-09
• Subjects: cost -- economic evaluation -- health-related quality of life -- outcome assessment -- patient-reported outcome-measures -- whiplash; Spine -- Abnormalities -- Periodicals; Spine -- Diseases -- Periodicals; Spine -- Surgery -- Periodicals; 616.73005
• DOI: 10.1097/BRS.0000000000001512
• Languages: English
• ISSNs: 0362-2436

Abstract

Abstract : Study Design: This study examines the links between severity of whiplash associated disorder and costs and health outcomes. Objective: The study aims to estimate the economic costs and health-state utilities associated with disability levels and recovery trajectories after acute whiplash injury. Summary of Background Data: Data used were from the Managing Injuries of the Neck Trial, which collected information on 3851 people over a 12-month period after acute whiplash injury. Methods: Effects of whiplash associated disorder severity on economic costs (measured from a societal perspective and separately from a health and personal social services perspective) were estimated using two-part regression models, comprising probability of incurring a cost and the total cost, given one was incurred. Effects on health-state utilities (measured using the EQ-5D and SF-6D) were estimated using ordinary least squares regression, and two-part models as for costs. Results: There was a direct relationship between severity of disability after acute whiplash injury and economic costs. Between baseline and 4 months, average societal costs for those with no disability were £99.55 (UK£, 2009 prices), increasing to £668.53 for those with complete disability. Average societal costs for the whole sample were £234.15 over the first 4 months, decreasing to £127.51 between 8 and 12 months. Conversely, utility scores decreased with increased disability. The average EQ-5D utility score was 0.934 at 4 months for those with no disability, decreasing to 0.033 for those with complete disability. The average EQ-5D utility score for the whole sample increased from 0.587 immediately post-injury to 0.817 at 12 months. Relative costs and disutilities generated by the multivariate models are also presented by disability level and recovery trajectory. Conclusion: These results provide estimates of the costs and health-state utilities associated with disability levels and recovery trajectories after acute whiplash injury. They can be used to inform estimates of the cost-effectiveness of interventions targeting whiplash-associated disorders. Level of Evidence: 3