Healthcare Utilization and Indirect Burden among Families of Pediatric Patients with Chronic Pain

Abstract

Objectives: Chronic pain is associated with substantial direct and indirect costs in adulthood. Chronic pain problems are also common in childhood, but little is known about the costs of pédiatrie chronic pain and its treatment. The objectives of this study were to examine and describe healthcare utilization and indirect burden among pédiatrie chronic pain patients and their families.Methods: Participants were parents of 75 pédiatrie patients with daily or almost daily pain for at least three months, seen at a multidisciplinary pédiatrie pain outpatient elinie. Information about healtheare use and indireet familial burden was obtained during a semi-structured interview at the patients' first visit to the pain clinic. A financial analyst extracted cost data regarding hospital 155 156 JOURNAL OF MUSCULOSKELETAL PAIN charges. To assess change over time, the same information was gathered from parents and the hospital financial analyst six months after their initial visit.Results: Parents reported numerous healthcare visits related to their child's pain condition [e.g., visits to specialists, physical therapy visits], high financial costs [e.g., charges for outpatient visits], and substantial indirect burden [e.g., time spent in medical appointments and missed workdays]. Parents reported lower healthcare utilization and decreased burden on families at the six-month follow-up assessment.Conclusions: Our results suggest that pédiatrie chronic pain is associated with considerable direct financial costs and indirect familial costs. Preliminary evidence suggests that involvement in a multidisciplinary program may be associated with decreased health care use and indirect burden.

Long-Term Outcomes of Adolescents With Juvenile-Onset Fibromyalgia in Early Adulthood

“…34 Items included the number of outpatient visits (primary care, specialty care, and counselor/psychologist visits) and emergency department visits within the past year.…”

The association between pediatric chronic pain clinic attendance and health care utilization: A retrospective analysis

“…8 Early pain management intervention can reduce pain duration, pain-related disability, and thus health care expenditures. [9][10][11] However, recent surveys have revealed unacceptably high levels of undertreatment and intolerably long wait times (often >1 year) to access appropriate chronic pain care in Canada. 11,12 Moreover, in 2007, Peng et al reported the status of dedicated multidisciplinary pediatric chronic pain clinics in Canada and found only five, leaving many provinces and regions without access to subspecialty pediatric chronic pain care.…”

“…[9][10][11] However, recent surveys have revealed unacceptably high levels of undertreatment and intolerably long wait times (often >1 year) to access appropriate chronic pain care in Canada. 11,12 Moreover, in 2007, Peng et al reported the status of dedicated multidisciplinary pediatric chronic pain clinics in Canada and found only five, leaving many provinces and regions without access to subspecialty pediatric chronic pain care. 13 In 2013, an unpublished updated review concluded that this number had increased to eight 14 and, since then, the number of Canadian pediatric chronic pain clinics has only increased to ten.…”

Lėtinis vaikų skausmas biopsichosocialiniu požiūriu: samprata, įvertinimo ir gydymo strategija

“…Šiai kompleksinei sveikatos problemai reikia visapusiško požiūrio į gydymą. Vaiko skausmas susijęs su tiesioginėmis ir netiesioginėmis lėšų sąnaudomis, skirtomis sveikatos priežiūrai, nes dažnai tėvai tam, kad galėtų rūpintis lėtinį skausmą patiriančiu vaiku, priversti mesti darbą, prarasdami darbo užmokestį [32,33]. Lygindami suaugusiųjų ir vaikų, kenčiančių nuo lėtinio skausmo, literatūroje aptinkamus duomenis, randame, kad vaikams, patiriantiems lėtinį skausmą, reikia daugiau sveikatos priežiūrai skiriamų resursų [34], jie dažnai patiria komorbidinių psichologinių ir socialinių problemų [27,35].…”