gms | German Medical Science

Background and status of research: A 2007 survey estimated that 85% of Germans experience lower back pain (LBP) in their lifetime [1]. LBP has been identified as being a major source of resource use in the German “out of hours health care system” [1]. In Germany, atraumatic LBP (i.e., LBP without injury or clear cause), as defined by the three-digit ICD-10 code: M54, was the most frequent diagnosis (3.7%) for all patients and the leading diagnosis for ambulatory patients in the emergency department (4.7%) [results of the INDEED-Study, manuscript in preparation].

Question and objective, hypothesis: The objective of this analysis is to identify the demographic and clinical characteristics of patients with atraumatic LBP, who have statutory health insurance, in the ED and their “cross-sectoral patient journey” within the German outpatient healthcare system.

Methods: The INDEED study (utilization and trans-sectoral patterns of care for patients admitted to emergency departments in Germany) is a retrospective study of 454,747 ED treatment cases in 2016 who visited the ED of one of 16 participating hospitals with linkage of the respective statutory health insurance data (Kassenärztliche Vereinigung, [KV]) from 2014-2017 [2]. Demographic and clinical characteristics will be described for patients admitted to the ED with atraumatic LBP. Using the insurance data of ED patients with LBP, we will identify the frequency of their visits to ambulatory physicians who were contracted by KVs before and after the ED consultation.

Results: The data are currently being analysed. The results of this study will include the characterization of patients attending the ED for LBP in participating hospitals within Germany. We will describe outpatient care before and after ED visit including information on treatment, frequency of outpatient visits, and the type of ambulatory doctors who were contracted by the KVs. Additionally, a description of the differences in patients who had a prior diagnosis of chronic LBP before their first ED visit and those who were not diagnosed with LBP up to two years before their first ED visit in 2016 will be provided. Moreover, we will examine the differences between LBP patients admitted to the hospital from the ED compared to those discharged directly from the ED.

Discussion: This analysis will provide characteristics of LBP patients from statutory health insurance companies attending the ED and their patient journey in the outpatient setting regarding their LBP treatment.

Implications for care: These results may identify needs of LBP patients that could be addressed to improve their medical care.