BACKGROUND AND AIMS: The socioeconomic burden of LBP is very high. A minority of patients visits secondary or tertiary care because of severe and long lasting complaints. The objective was to study the personal and societal impact of LBP in patients admitted to a secondary/tertiary multidisciplinary spine center.
METHODS: Baseline data were acquired through patient-reported questionnaires and health insurance claims. Primary outcomes were LBP impact (Impact Stratification, range 8-50), functioning (Pain Disability Index, PDI; 0-70), quality of life (EuroQol-5D, EQ5D; -0.33-1.00), work ability (Work Ability Score, WAS; 0-10), work participation, productivity costs (Productivity Cost Questionnaire, iPCQ), and healthcare costs one year prior to baseline. Healthcare costs were compared with matched primary and secondary care LBP samples. 
RESULTS: In total 1502 patients (age 46.3±12.8 years, 57% female) were included. Impact Stratification was 35.2±7.5 with severe impact (≥35) for 58% of patients. PDI was 38.2±14.1, EQ5D 0.39 (interquartile range, IQR: 0.17;0.72); WAS 4.0 (IQR: 1.0;6.0) and 17% was permanently work disabled. Mean total healthcare costs (€4875, 95% CI: 4309;5498) were higher compared to the matched primary care sample (n=4995) (€2365, 95% CI: 2219;2526, p<0.001), and similar to the matched secondary care sample (n=4993) (€4379, 95% CI: 4180;4590). Productivity loss was estimated at €4315 per patient (95% CI: 3898;4688) over six months. 
CONCLUSIONS: In patients seeking multidisciplinary spine care, the personal and societal impact of LBP is very high. Specifically, quality of life and work ability are poor and healthcare costs are twice as high compared to patients seeking primary LBP care.

03 - PERSONAL AND SOCIETAL IMPACT OF LOW BACK PAIN; THE GRONINGEN SPINE COHORT