Using hospital data and routines to estimate costs and effects of integrative care programmes for chronic pain and stress disorders--a feasibility study.

Abstract

Background: Evidence of cost and effects for comprehensive hospital-based integrative care (IC) is scarce. The aim of this study was to explore the feasibility of using local hospital data and routines to estimate costs and effects of anthroposophic IC programmes for chronic pain and stress disorders in Sweden.

Methods: Retrospective analysis of one IC hospital's local administrative registry data. Main outcomes embraced patient demographics, programme duration and costs, patients' health status (EQ-5D index, 0-1) and self-rated health (EQ-5D VAS, 0-100), from hospital admittance to discharge. The use of postal questionnares for collecting follow-up data after hospital discharge was assessed.

Results: The IC pain programme had 461 records, all with complete data on costs and duration: average programme cost, EUR 5,925 (95% CI 5,780-6,070), and duration, 17.8 (SD 4.7) days. The IC stress programme had 263 records, all with complete cost and duration data: programme cost, EUR 5,494 (95%CI 5,318-5,671); duration 18.0 (SD 4.7) days. From admittance to discharge, health status improved by 0.23 (95% CI 0.19-0.27) in the pain, and by 0.16 (95% CI 0.12-0.20) in the stress programme. Improvements in self-rated health were 20 (95% CI 18-22), and 21 (95% CI 18-23), respectively. There was a general decrease in questionnaire response rate after hospital discharge, whereby 27-32% of respondents had completed data after 9 months.

Conclusions: It was feasible to use hospital registry data to estimate costs and show positive effects of anthroposophic IC programmes for pain and stress disorders in Sweden. Clinical implications and the need for long-term follow-up are discussed.