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Interdisciplinary pain clinic treatment significantly decreased the primary care and emergency department healthcare utilization among children with chronic pain.
Children suffering from chronic pain have high and expensive healthcare utilization. There is a scarcity of data regarding the influence of interdisciplinary pediatric pain treatment on healthcare utilization.
A group of investigators at the University of Washington School of Medicine & Seattle Children's Research Institute carried out a research to assess the change in health care utilization among 273 children who underwent evaluation and treatment at 15 North American interdisciplinary pain clinics.
The parents reported data on healthcare utilization during the past year at the initial pain clinic evaluation (baseline) and one-year follow-up. The change in utilization across time was measured by Wilcoxon signed rank tests. The findings showed that there was a significant decrease in primary care (baseline: M=6.3, SD=16.8, IQR =0.0-6.0 vs. follow-up: M=3.3, SD=8.5, IQR=0.0-3.0, p<.01) and emergency department (ED baseline: M=1.5, SD=2.8, IQR=0-2.0 vs. follow-up: M=0.89, SD=2.16, IQR=0.0-1.0, p<.01) utilization from baseline to follow-up. There was no considerable change in the utilization of mental health, physical/occupational therapy or complementary/alternative medicine.
Zero-inflated negative binomial regression analyses reviewed the baseline utilization, pain (location/intensity), and demographics, socioeconomic status [SES], child age/sex/race as predictors of utilization at one-year follow-up. Higher follow-up ED utilization was predicted by higher baseline ED utilization (B=1.10, p=0.002), US residency (B=2.19, p=0.008), female sex (B=2.12, p=0.049), and non-Caucasian race (B=1.89, p=0.04). Primary care utilization was foretold by female sex (B=3.54, p=0.005). Mental health utilization was predicted by higher baseline mental health utilization (B=1.045, p=0.001) and higher SES (B=1.49, p=0.04). Significant predictors of PT/OT or CAM utilization were not identified.
The overall results of the study show that interdisciplinary pediatric pain clinic treatment may reduce ED and primary care utilization. There is a need to conduct future studies to interpret these findings in terms of costs to assess possible cost-savings of interdisciplinary pediatric pain clinic treatment.
The Journal of Pain
Interdisciplinary pain clinic treatment may reduce health care utilization among youth with chronic pain
E. Law et al.
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