Severe forms of fibromyalgia with acute exacerbation of pain: costs, comorbidities, and length of stay in inpatient care

Figures & data

Figure 1 Acute inpatient treatment: patient-specific examinations.

Abbreviation: G-AEP, German appropriateness-evaluation protocol.

Table 1 Patient-related inclusion criteria for interdisciplinary patient-centered care

Multimodal complex rheumatologic treatment, OPS 8-983	Multimodal pain management, OPS 8-918	Naturopathic complex therapy, OPS 8-975
Path entry criteria: defined by the hospital	Path entry criteria: defined in German operation and procedure code (Operationen- und Prozedurenschlüssel [OPS])	Path entry criteria: the guidelines^Citation46 represent the current state of naturopathic specialist opinion as to which conditions are generally necessary such that a chronically ill patient will be admitted to hospital for inpatient naturopathic complex therapy^Citation47
Reduced functional capacity	Manifest or threatening impairment of quality of life and/or ability to work	It must be ensured that it would not be possible to achieve the therapeutic target by means of inpatient rehabilitation
Activity of rheumatic disease	Failure of a previous unimodal pain therapy, a pain-related operative intervention, or a withdrawal therapy	The degree of chronicity must be evaluated analogously to the Mainz stage model of pain chronicity (Mainz Pain Staging System), referring to the individual type and intensity of the symptoms
Manifest or threatening impairment of quality of life and/or ability to work	Existing drug dependence or drug misuse	The symptomatic intensity should be evaluated, eg, analogously to the von Korff model for chronic complaints, referring to the individual type and intensity of the symptoms
Multiple pain	Serious concomitant mental disorder Serious concomitant somatic disease	The clinical picture involves at least three different sections of the International Classification of Diseases

Note: Data from Romeyke and Stummer.²⁶

Table 2 Analysis of additional FMS diagnoses in accordance with the International Statistical Classification of Diseases and Related Health Problems, tenth revision

Chapter	Block	n	Title
I	A00–B99	7	Certain infectious and parasitic diseases
II	C00–D48	3	Neoplasms
III	D50–D89	17	Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
IV	E00–E90	285	Endocrine, nutritional, and metabolic diseases
V	F00–F99	225	Mental and behavioral disorders
VI	G00–G99	218	Diseases of the nervous system
VII	H00–H59	11	Diseases of the eye and adnexa
VIII	H60–H95	12	Diseases of the ear and mastoid process
IX	I00–I99	114	Diseases of the circulatory system
X	J00–J99	39	Diseases of the respiratory system
XI	K00–K93	53	Diseases of the digestive system
XII	L00–L99	10	Diseases of the skin and subcutaneous tissue
XIII	M00–M99	420	Diseases of the musculoskeletal system and connective tissue
XIV	N00–N99	28	Diseases of the genitourinary system
XV	O00–O99	0	Pregnancy, childbirth, and the puerperium
XVI	P00–P96	0	Certain conditions originating in the perinatal period
XVII	Q00–Q99	3	Congenital malformations, deformations, and chromosomal abnormalities
XVIII	R00–R99	72	Symptoms, signs, and abnormal clinical and laboratory findings not elsewhere classified
XIX	S00–T98	19	Injury, poisoning, and certain other consequences of external causes
XX	V01–Y98	0	External causes of morbidity and mortality
XXI	Z00–Z99	36	Factors influencing health status and contact with health services
XXII	U00–U85	0	Codes for special purposes

Abbreviation: FMS, fibromyalgia syndrome.

Figure 2 Average costs per cost-category group.

Figure 3 Distribution of average total costs.

Figure 4 Additional fibromyalgia-syndrome diagnoses in the cost-driving group.

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