Increasing severity was associated with an increased number of physician visits, though no differences (with the exception of the comparison between patients with severe pain and matched no LBP controls, in terms of ER visits) were observed on other health care resource utilization events. Only patients with severe pain had marginally higher estimated direct costs than did matched no LBP controls. This is a weaker pattern than that observed in the United States,7 although beyond fundamental cultural and health care system differences, there were also differences in method (eg, claims analysis vs patient-reported) that may account for the discrepancy.