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Magnusson, Henrik
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Publications (10 of 15) Show all publications
Waldén, M., Hägglund, M., Magnusson, H. & Ekstrand, J. (2016). ACL injuries in mens professional football: a 15-year prospective study on time trends and return-to-play rates reveals only 65% of players still play at the top level 3 years after ACL rupture. British Journal of Sports Medicine, 50(12), 744-750
Open this publication in new window or tab >>ACL injuries in mens professional football: a 15-year prospective study on time trends and return-to-play rates reveals only 65% of players still play at the top level 3 years after ACL rupture
2016 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 50, no 12, p. 744-750Article in journal (Refereed) Published
Abstract [en]

Background Studies investigating the development of ACL injuries over time in football are scarce and more data on what happens before and after return to play (RTP) are needed. Aim To investigate (1) time trends in ACL injury rates, (2) complication rates before return to match play following ACL reconstruction, and (3) the influence of ACL injury on the subsequent playing career in male professional football players. Methods 78 clubs were followed between 2001 and 2015. Time trend in ACL injury rate was analysed using linear regression. ACL-injured players were monitored until RTP and tracked for 3 years after RTP. Results We recorded 157 ACL injuries, 140 total and 17 partial ruptures, with a non-significant average annual increase in the ACL injury rate by 6% (R-2=0.13, b=0.059, 95% CI -0.04 to 0.15, p=0.20). The match ACL injury rate was 20-fold higher than the training injury rate (0.340 vs 0.017 per 1000 h). 138 players (98.6%) with a total rupture underwent ACL reconstruction; all 134 players with RTP data (4 players still under rehabilitation) were able to return to training, but 9 of them (6.7%) suffered complications before their first match appearance (5 reruptures and 4 other knee surgeries). The median layoff after ACL reconstruction was 6.6 months to training and 7.4 months to match play. We report 3-year follow-up data for 106 players in total; 91 players (85.8%) were still playing football and 60 of 93 players (65%) with ACL reconstruction for a total rupture played at the same level. Conclusions The ACL injury rate has not declined during the 2000s and the rerupture rate before return to match play was 4%. The RTP rate within a year after ACL reconstruction was very high, but only two-thirds competed at the highest level 3 years later.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2016
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:liu:diva-129482 (URN)10.1136/bjsports-2015-095952 (DOI)000376762000010 ()27034129 (PubMedID)
Note

Funding Agencies|UEFA; Swedish Football Association; Football Association Premier League Limited; Swedish National Centre for Research in Sports

Available from: 2016-06-21 Created: 2016-06-20 Last updated: 2017-11-28
Fältström, A., Hägglund, M., Magnusson, H., Forssblad, M. & Kvist, J. (2016). Predictors for additional anterior cruciate ligament reconstruction: data from the Swedish national ACL register.. Knee Surgery, Sports Traumatology, Arthroscopy, 24(3), 885-894
Open this publication in new window or tab >>Predictors for additional anterior cruciate ligament reconstruction: data from the Swedish national ACL register.
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2016 (English)In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 24, no 3, p. 885-894Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To identify predictors for additional anterior cruciate ligament (ACL) reconstruction.

METHODS: Patients from the Swedish national ACL register who underwent ACL reconstruction between January 2005 and February 2013 (follow-up duration 6-104 months) were included. Cox regression analyses included the following independent variables regarding primary injury: age, sex, time between injury and primary ACL reconstruction, activity at primary injury, concomitant injuries, injury side, graft type, and pre-surgery KOOS and EQ-5D scores.

RESULTS: Among ACL reconstruction procedures, 93 % involved hamstring tendon (HT) autografts. Graft type did not predict additional ACL reconstruction. Final regression models only included patients with HT autograft (n = 20,824). Of these, 702 had revision and 591 contralateral ACL reconstructions. The 5-year post-operative rates of revision and contralateral ACL reconstruction were 4.3 and 3.8 %, respectively. Significant predictors for additional ACL reconstruction were age (fourfold increased rate for <16-year-old patients vs. >35-year-old patients), time between injury and primary surgery (two to threefold increased rate for ACL reconstruction within 0-90 days vs. >365 days), and playing football at primary injury.

CONCLUSION: This study identified younger age, having ACL reconstruction early after the primary injury, and incurring the primary injury while playing football as the main predictors for revision and contralateral ACL reconstruction. This suggests that the rate of additional ACL reconstruction is increased in a selected group of young patients aiming to return to strenuous sports after primary surgery and should be taken into consideration when discussing primary ACL reconstruction, return to sports, and during post-surgery rehabilitation. LEVEL OF EVIDENCE: II.

National Category
Physiotherapy Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-115943 (URN)10.1007/s00167-014-3406-6 (DOI)000371300400036 ()25366191 (PubMedID)
Note

Funding agencies:The study was financially supported by Futurum-the academy for healthcare, County Council, Jonkoping, the Faculty of Health Sciences at Linkoping University, and the Swedish National Centre for Research in Sports (CIF).

Available from: 2015-03-24 Created: 2015-03-24 Last updated: 2018-10-29Bibliographically approved
Gauffin, H., Tagesson (Sonesson), S., Meunier, A., Magnusson, H. & Kvist, J. (2014). Knee arthroscopic surgery is beneficial to middle-aged patients with meniscal symptoms: a prospective, randomised, single-blinded study. Osteoarthritis and Cartilage, 22(11), 1808-1816
Open this publication in new window or tab >>Knee arthroscopic surgery is beneficial to middle-aged patients with meniscal symptoms: a prospective, randomised, single-blinded study
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2014 (English)In: Osteoarthritis and Cartilage, ISSN 1063-4584, E-ISSN 1522-9653, Vol. 22, no 11, p. 1808-1816Article in journal (Refereed) Published
Abstract [en]

Objective: There is no evidence that a knee arthroscopy is more beneficial to middle-aged patients with meniscal symptoms compared to other treatments. This randomised controlled trial aimed to determine whether an arthroscopic intervention combined with a structured exercise programme would provide more benefit than a structured exercise programme alone for middle-aged patients with meniscal symptoms that have undergone physiotherapy. Method: 150 out of 179 eligible patients, aged 45 to 64 (mean: 54 +/- 5), symptom duration more than 3 months and standing X-ray with Ahlback grade 0, were randomised to: (1) a physiotherapy appointment within 2 weeks of inclusion that included instructions for a 3-month exercise programme (non-surgery group); or (2) the same as (1) plus, within 4 weeks of inclusion, knee arthroscopy for resection of any significant meniscal injuries (surgery group). The primary outcome was change in pain at 12 months, assessed with the Knee Injury and Osteoarthritis Outcome Score (KOOSPAIN). Results: In the Intention-To-Treat analysis, pain at 12 months was significantly lower in the surgery than in the non-surgery group. The change in KOOSPAIN was significantly larger in the surgery than in the non-surgery group (between-group difference was 10.6 points of change; 95% CI: 3.4 to 17.7, P = 0.004). The As-Treated analysis results were consistent with the Intention-To-Treat analysis results. Conclusion: Middle-aged patients with meniscal symptoms may benefit from arthroscopic surgery in addition to a structured exercise programme. Patients age or symptom history (i.e., mechanical symptoms or acute onset of symptoms) didnt affect the outcome.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
Knee arthroscopy; Menisci; Meniscectomy
National Category
Clinical Medicine Orthopaedics Health Sciences
Identifiers
urn:nbn:se:liu:diva-112629 (URN)10.1016/j.joca.2014.07.017 (DOI)000344186000006 ()25086401 (PubMedID)
Available from: 2014-12-08 Created: 2014-12-05 Last updated: 2018-01-11Bibliographically approved
Ekstrand, J., Hägglund, M., Kristenson, K., Magnusson, H. & Walden, M. (2013). Fewer ligament injuries but no preventive effect on muscle injuries and severe injuries: an 11-year follow-up of the UEFA Champions League injury study. British Journal of Sports Medicine, 47(12), 732-+
Open this publication in new window or tab >>Fewer ligament injuries but no preventive effect on muscle injuries and severe injuries: an 11-year follow-up of the UEFA Champions League injury study
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2013 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 47, no 12, p. 732-+Article in journal (Refereed) Published
Abstract [en]

Background less thanbrgreater than less thanbrgreater thanLimited information is available on the variation in injury rates over multiple seasons of professional football. less thanbrgreater than less thanbrgreater thanAim less thanbrgreater than less thanbrgreater thanTo analyse time-trends in injury characteristics of male professional football players over 11 consecutive seasons. less thanbrgreater than less thanbrgreater thanMethods less thanbrgreater than less thanbrgreater thanA total of 1743 players comprising 27 teams from 10 countries were followed prospectively between 2001 and 2012. Team medical staff recorded individual player exposure and time loss injuries. less thanbrgreater than less thanbrgreater thanResults less thanbrgreater than less thanbrgreater thanA total of 8029 time loss injuries were recorded. The match unavailability due to injury was 14% and constant over the study period. On average, a player sustained two injuries per season, resulting in approximately 50 injuries per team and season. The ligament injury rate decreased during the study period (R-2=0.608, b=-0.040, 95% CI -0.065 to -0.016, p=0.005), whereas the rate of muscle injury (R-2=0.228, b=-0.013, 95% CI -0.032 to 0.005, p=0.138) and severe injury (R-2=0.141, b=0.015, 95% CI -0.013 to 0.043, p=0.255) did not change over the study period. In addition, no changes in injury rates over the 11-year period were found for either training (R-2=0.000, b=0.000, 95% CI -0.035 to 0.034, p=0.988) or match play (R-2=0.282, b=-0.015, 95% CI -0.032 to 0.003, p=0.093). less thanbrgreater than less thanbrgreater thanConclusions less thanbrgreater than less thanbrgreater thanThe injury rate has decreased for ligament injuries over the last 11years, but overall training, match injury rates and the rates of muscle injury and severe injury remain high.

Place, publisher, year, edition, pages
BMJ Publishing Group, 2013
Keywords
Epidemiology, Injury Prevention, Hamstring injuries, Lower extremity injuries, Soccer
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-97456 (URN)10.1136/bjsports-2013-092394 (DOI)000322868800006 ()
Note

Funding Agencies|UEFA||Swedish National Centre for Research in Sports and Praktikertjanst AB||

Available from: 2013-09-12 Created: 2013-09-12 Last updated: 2017-12-06
Hägglund, M., Walden, M., Magnusson, H., Kristenson, K., Bengtsson, H. & Ekstrand, J. (2013). Injuries affect team performance negatively in professional football: an 11-year follow-up of the UEFA Champions League injury study. British Journal of Sports Medicine, 47(12), 738-742
Open this publication in new window or tab >>Injuries affect team performance negatively in professional football: an 11-year follow-up of the UEFA Champions League injury study
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2013 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 47, no 12, p. 738-742Article in journal (Refereed) Published
Abstract [en]

Background The influence of injuries on team performance in football has only been scarcely investigated.

Aim To study the association between injury rates and team performance in the domestic league play, and in European cups, in male professional football.

Methods 24 football teams from nine European countries were followed prospectively for 11 seasons (2001–2012), including 155 team-seasons. Individual training and match exposure and time-loss injuries were registered. To analyse the effect of injury rates on performance, a Generalised Estimating Equation was used to fit a linear regression on team-level data. Each team's season injury rate and performance were evaluated using its own preceding season data for comparison in the analyses.

Results 7792 injuries were reported during 1 026 104 exposure hours. The total injury incidence was 7.7 injuries/1000 h, injury burden 130 injury days lost/1000 h and player match availability 86%. Lower injury burden (p=0.011) and higher match availability (p=0.031) were associated with higher final league ranking. Similarly, lower injury incidence (p=0.035), lower injury burden (p<0.001) and higher match availability (p<0.001) were associated with increased points per league match. Finally, lower injury burden (p=0.043) and higher match availability (p=0.048) were associated with an increase in the Union of European Football Association (UEFA) Season Club Coefficient, reflecting success in the UEFA Champions League or Europa League.

Conclusions Injuries had a significant influence on performance in the league play and in European cups in male professional football. The findings stress the importance of injury prevention to increase a team's chances of success.

Place, publisher, year, edition, pages
BMJ Publishing Group, 2013
Keywords
Elite performance, Epidemiology, Injury Prevention, Soccer, Sporting injuries
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-97449 (URN)10.1136/bjsports-2013-092215 (DOI)000322868800007 ()
Note

Funding Agencies|Union of European Football Associations (UEFA)||Swedish National Centre for Research in Sports and Praktikertjanst AB||

Available from: 2013-09-12 Created: 2013-09-12 Last updated: 2017-12-06Bibliographically approved
Gajhede-Knudsen, M., Ekstrand, J., Magnusson, H. & Maffulli, N. (2013). Recurrence of Achilles tendon injuries in elite male football players is more common after early return to play: an 11-year follow-up of the UEFA Champions League injury study. British Journal of Sports Medicine, 47(12), 763-768
Open this publication in new window or tab >>Recurrence of Achilles tendon injuries in elite male football players is more common after early return to play: an 11-year follow-up of the UEFA Champions League injury study
2013 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 47, no 12, p. 763-768Article in journal (Refereed) Published
Abstract [en]

Background There is limited information about Achilles tendon disorders in professional football. less thanbrgreater than less thanbrgreater thanAims To investigate the incidence, injury circumstances, lay-off times and reinjury rates of Achilles tendon disorders in male professional football. less thanbrgreater than less thanbrgreater thanMethods A total of 27 clubs from 10 countries and 1743 players have been followed prospectively during 11 seasons between 2001 and 2012. The team medical staff recorded individual player exposure and time-loss injuries. less thanbrgreater than less thanbrgreater thanResults A total of 203 (2.5% of all injuries) Achilles tendon disorders were registered. A majority (96%) of the disorders were tendinopathies, and nine were partial or total ruptures. A higher injury rate was found during the preseason compared with the competitive season, 0.25 vs 0.18/1000 h (rate ratio (RR) 1.4, 95% CI 1.1 to 2.0; p=0.027). The mean lay-off time for Achilles tendinopathies was 23 +/- 37 (median=10, Q(1)=4 and Q(3)=24) days, while a rupture of the Achilles tendon, on average, caused 161 +/- 65 (median=169, Q(1)=110 and Q(3)=189) days of absence. Players with Achilles tendon disorders were significantly older than the rest of the cohort, with a mean age of 27.2 +/- 4 years vs 25.6 +/- 4.6 years (pandlt;0.001). 27% of all Achilles tendinopathies were reinjuries. A higher reinjury risk was found after short recovery periods (31%) compared with longer recovery periods (13%) (RR 2.4, 95% CI 2.1 to 2.8; pandlt;0.001). less thanbrgreater than less thanbrgreater thanConclusions Achilles tendon disorders account for 3.8% of the total lay-off time and are more common in older players. Recurrence is common after Achilles tendinopathies and the reinjury risk is higher after short recovery periods.

Place, publisher, year, edition, pages
BMJ Publishing Group, 2013
Keywords
Achilles tendon, Elite performance, Epidemiology, Lower extremity injuries, Soccer
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-97447 (URN)10.1136/bjsports-2013-092271 (DOI)000322868800012 ()
Note

Funding Agencies|Union of European Football Associations (UEFA)||Swedish National Centre for Research in Sports||Praktikertjanst AB||

Available from: 2013-09-12 Created: 2013-09-12 Last updated: 2017-12-06
Ekstrand, J., Askling, C., Magnusson, H. & Mithoefer, K. (2013). Return to play after thigh muscle injury in elite football players: implementation and validation of the Munich muscle injury classification. British Journal of Sports Medicine, 47(12), 769-774
Open this publication in new window or tab >>Return to play after thigh muscle injury in elite football players: implementation and validation of the Munich muscle injury classification
2013 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 47, no 12, p. 769-774Article in journal (Refereed) Published
Abstract [en]

Background Owing to the complexity and heterogeneity of muscle injuries, a generally accepted classification system is still lacking. less thanbrgreater than less thanbrgreater thanAims To prospectively implement and validate a novel muscle injury classification and to evaluate its predictive value for return to professional football. less thanbrgreater than less thanbrgreater thanMethods The recently described Munich muscle injury classification was prospectively evaluated in 31 European professional male football teams during the 2011/2012 season. Thigh muscle injury types were recorded by team medical staff and correlated to individual player exposure and resultant time-loss. less thanbrgreater than less thanbrgreater thanResults In total, 393 thigh muscle injuries occurred. The muscle classification system was well received with a 100% response rate. Two-thirds of thigh muscle injuries were classified as structural and were associated with longer lay-off times compared to functional muscle disorders (pandlt;0.001). Significant differences were observed between structural injury subgroups (minor partial, moderate partial and complete injuries) with increasing lay-off time associated with more severe structural injury. Median lay-off time of functional disorders was 5-8 days without significant differences between subgroups. There was no significant difference in the absence time between anterior and posterior thigh injuries. less thanbrgreater than less thanbrgreater thanConclusions The Munich muscle classification demonstrates a positive prognostic validity for return to play after thigh muscle injury in professional male football players. Structural injuries are associated with longer average lay-off times than functional muscle disorders. Subclassification of structural injuries correlates with return to play, while subgrouping of functional disorders shows less prognostic relevance. Functional disorders are often underestimated clinically and require further systematic study.

Place, publisher, year, edition, pages
BMJ Publishing Group, 2013
Keywords
Hamstring injuries, MRI, Soccer, Muscle damage, injuries, Muscle injury and inflammation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-97451 (URN)10.1136/bjsports-2012-092092 (DOI)000322868800013 ()
Available from: 2013-09-12 Created: 2013-09-12 Last updated: 2017-12-06
Lundblad, M., Walden, M., Magnusson, H., Karlsson, J. & Ekstrand, J. (2013). The UEFA injury study: 11-year data concerning 346 MCL injuries and time to return to play. British Journal of Sports Medicine, 47(12), 759-+
Open this publication in new window or tab >>The UEFA injury study: 11-year data concerning 346 MCL injuries and time to return to play
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2013 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 47, no 12, p. 759-+Article in journal (Refereed) Published
Abstract [en]

Background Medial collateral ligament (MCL) injury is the most common knee ligament injury in professional football. less thanbrgreater than less thanbrgreater thanAim To investigate the rate and circumstances of MCL injuries and development over the past decade. less thanbrgreater than less thanbrgreater thanMethods Prospective cohort study, in which 27 professional European teams were followed over 11 seasons (2001/2002 to 2011/2012). Team medical staffs recorded player exposure and time loss injuries. MCL injuries were classified into four severity categories. Injury rate was defined as the number of injuries per 1000 player-hours. less thanbrgreater than less thanbrgreater thanResults 346 MCL injuries occurred during 1057 201 h (rate 0.33/1000 h). The match injury rate was nine times higher than the training injury rate (1.31 vs 0.14/1000 h, rate ratio 9.3, 95% CI 7.5 to 11.6, pandlt;0.001). There was a significant average annual decrease of approximately 7% (p=0.023). The average lay-off was 23 days, and there was no difference in median lay-off between index injuries and reinjuries (18 vs 13, p=0.20). Almost 70% of all MCL injuries were contact-related, and there was no difference in median lay-off between contact and non-contact injuries (16 vs 16, p=0.74). less thanbrgreater than less thanbrgreater thanConclusions This largest series of MCL injuries in professional football suggests that the time loss from football for MCL injury is 23 days. Also, the MCL injury rate decreased significantly during the 11-year study period.

Place, publisher, year, edition, pages
BMJ Publishing Group, 2013
Keywords
Knee, Epidemiology, Injury Prevention, Knee injuries, Soccer
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-97455 (URN)10.1136/bjsports-2013-092305 (DOI)000322868800011 ()
Note

Funding Agencies|UEFA||Swedish Centre for Research in Sports||Praktikertjanst AB||

Available from: 2013-09-12 Created: 2013-09-12 Last updated: 2017-12-06
Ekstrand, J., Hägglund, M., Tornqvist, H., Kristenson, K., Bengtsson, H., Magnusson, H. & Waldén, M. (2013). Upper extremity injuries in male elite football players. Knee Surgery, Sports Traumatology, Arthroscopy, 21(7), 1626-1632
Open this publication in new window or tab >>Upper extremity injuries in male elite football players
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2013 (English)In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 21, no 7, p. 1626-1632Article in journal (Refereed) Published
Abstract [en]

To investigate the epidemiology of upper extremity injuries in male elite football players and to describe their characteristics, incidence and lay-off times. less thanbrgreater than less thanbrgreater thanBetween 2001 and 2011, 57 male European elite football teams (2,914 players and 6,215 player seasons) were followed prospectively. Time-loss injuries and exposure to training and matches were recorded on individual basis. less thanbrgreater than less thanbrgreater thanIn total, 11,750 injuries were recorded, 355 (3 %) of those affected the upper extremities giving an incidence of 0.23 injuries/1,000 h of football. The incidence in match play was almost 7 times higher than in training (0.83 vs. 0.12 injuries/1,000 h, rate ratio 6.7, 95 % confidence interval 5.5-8.3). As much as 32 % of traumatic match injuries occurred as a result of foul play situations. Goalkeepers had a significantly higher incidence of upper extremity injuries compared to outfield players (0.80 vs. 0.16 injuries/1,000 h, rate ratio 5.0, 95 % confidence interval 4.0-6.2). The average absence due to an upper extremity injury was 23 +/- A 34 days. less thanbrgreater than less thanbrgreater thanUpper extremity injuries are uncommon among male elite football players. Goalkeepers, however, are prone to upper extremity injury, with a five times higher incidence compared to outfield players. less thanbrgreater than less thanbrgreater thanII.

Place, publisher, year, edition, pages
Springer Verlag (Germany), 2013
Keywords
Soccer, Incidence, Lay-off times, Re-injury, Goalkeeper
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-95958 (URN)10.1007/s00167-012-2164-6 (DOI)000320672600024 ()
Note

Funding Agencies|UEFA||Swedish Centre for Research in Sports||Praktikertjanst AB||

Available from: 2013-08-19 Created: 2013-08-12 Last updated: 2017-12-06
Carstensen, J., Andersson, D., André, M., Engström, S., Magnusson, H. & Borgquist, L. (2012). How does comorbidity influence healthcare costs? A population-based cross-sectional study of depression, back pain and osteoarthritis. BMJ Open, 2, e000809
Open this publication in new window or tab >>How does comorbidity influence healthcare costs? A population-based cross-sectional study of depression, back pain and osteoarthritis
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2012 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 2, p. e000809-Article in journal (Refereed) Published
Abstract [en]

Objectives To analyse how comorbidity among patients with back pain, depression and osteoarthritis influences healthcare costs per patient. A special focus was made on the distribution of costs for primary healthcare compared with specialist care, hospital care and drugs.

Design Population-based cross-sectional study.

Setting The County of Östergötland, Sweden.

Patients Data on diagnoses and healthcare costs for all 266 354 individuals between 20 and 75 years of age, who were residents of the County of Östergötland, Sweden, in the year 2006, were extracted from the local healthcare register and the national register of drug prescriptions.

Main outcome measures The effects of comorbidity on healthcare costs were estimated as interactions in regression models that also included age, sex, number of other health conditions and education.

Results The largest diagnosed group was back pain (11 178 patients) followed by depression (7412 patients) and osteoarthritis (5174 patients). The largest comorbidity subgroup was the combination of back pain and depression (772 patients), followed by the combination of back pain and osteoarthritis (527 patients) and the combination of depression and osteoarthritis (206 patients). For patients having both a depression diagnosis and a back pain diagnosis, there was a significant negative interaction effect on total healthcare costs. The average healthcare costs among patients with depression and back pain was SEK 11 806 lower for a patient with both diagnoses. In this comorbidity group, there were tendencies of a positive interaction for general practitioner visits and negative interactions for all other visits and hospital days. Small or no interactions at all were seen between depression diagnoses and osteoarthritis diagnoses.

Conclusions A small increase in primary healthcare visits in comorbid back pain and depression patients was accompanied with a substantial reduction in total healthcare costs and in hospital costs. Our results can be of value in analysing the cost effects of comorbidity and how the coordination of primary and secondary care may have an impact on healthcare costs.

National Category
Health Care Service and Management, Health Policy and Services and Health Economy General Practice
Identifiers
urn:nbn:se:liu:diva-77845 (URN)10.1136/bmjopen-2011-000809 (DOI)000315042100071 ()
Available from: 2012-05-31 Created: 2012-05-31 Last updated: 2018-01-12
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