4.7. Economic analysis (IV and V)

The economic analysis, which concerned the use and costs of health care services and help at home, was based on the responses to the 4-week, 3-month, 6-month and 1-year follow-up questionnaires. The cost of the infiltration procedure itself ($200) was not included in the saline group. The charge of MRI ($550) was included in the costs for both groups. Data on days of sick leave and costs of medication were obtained from the National Insurance Register. Because of the controversy over human capital and friction cost analysis, the monetary value of sick leaves was not assessed (Hutubessy et al. 1999). All additional treatments and visits to physiotherapists, osteopaths and physicians were estimated from the data entered on the questionnaires and from medical records. For the costs of physician and physiotherapist visits, the charges of the University Hospital were used ($55 for a physician visit and $38 for a physiotherapist visit). Data on back operations were gathered from the questionnaires and from medical records. The cost of a discectomy at the University Hospital ($3215) includes three inpatient postoperative days, with additional days costing $205. Home help was defined as help from the patient’s spouse, children, relatives or friends. The monetary value of 1 hour of home help was taken as the hourly wage of a munipical home helper ($9). Dollar costs were calculated at the 1998 exchange rate ($1=5.096 Finnish marks).