5O-2
ONE YEAR HEALTHCARE COST AND UTILIZATION IN ADULTS WITH CHRONIC PAIN
Wednesday, October 21, 2015: 10:15 AM
Grand Ballroom C (Hyatt Regency St. Louis at the Arch)
Mary-Ellen Hogan, BScPhm, PharmD, MSc, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada, Vibhuti Shah, MD MSc, Institute of Health Policy, Management and Evaluation, University of Toronto, Department of Paediatrics, Mount Sinai Hospital, Toronto, ON, Canada, Joel Katz, BA, MA, PhD, Department of Psychology, York University, Toronto General Research Institute and Department of Anesthesia and Pain Management, University Health Network, Toronto, ON, Canada, Anna Taddio, BScPhm, MSc, PhD, Leslie Dan Faculty of Pharmacy, University of Toronto; Department of Child Health Evaluative Sciences, Pharmacy, Hospital for Sick Children, Toronto, ON, Canada and Murray D Krahn, MD, MSc, FRCPC, Toronto Health Economics and Technology Assessment (THETA) Collaborative, University of Toronto, Toronto, ON, Canada
Purpose:
Approximately 19% of adults have chronic pain. Technologies
to treat chronic pain require cost estimates for cost-utility analyses. In
countries like Canada, with universal health coverage, costs borne by the
government payer are of greatest interest to decision makers.
Methods:
Adults (18-64 years) with and without chronic pain were
identified from the Canadian Community Health Survey (CCHS 2000-01, 2007-08,
2009-10). Ontario respondents were linked to their administrative data which
documents all publicly funded healthcare. This includes hospital stays,
emergency department use, physician visits, long-term and complex continuing
care, homecare, rehabilitation and drugs for those ≥65 years or on social
assistance. Adults with chronic pain were matched to those without using age,
sex, survey year, and a propensity score for having chronic pain; it was
estimated from a rurality index, income quintile and comorbidity (ADGs, Johns
Hopkins ACG system). Per-person costs and use of healthcare were estimated for
one year following survey response, adjusting for inflation. Incremental cost
was the difference in costs between individuals with pain and those without.
Results:
Chronic pain was reported by 13,129 (19%) of 67,619 CCHS
respondents. 12,207 (93%) with chronic pain were matched to respondents
without pain. 58% were female, mean age was 46 years (SD 12) and mean number
of ADGs was 4.1 (SD 2.8) for each of cases and their matched controls. One
year healthcare utilization was greater in the chronic pain group versus the control
group (p<0.01) for the following: patients with at least 10 physician
visits (56% vs 46%), at least 1 emergency department visit (32% vs 25%), at
least 1 hospital stay (20% vs 16%), at least 1 CT (15% vs 7%), and at least 1
MRI (7% vs 4%). Incremental costs were available for 8,298 pairs from CCHS
2007-08 and 2009-10, and are reported in the table.
Conclusions:
Adults with chronic pain used more services and costs were
greater than matched controls without chronic pain. The incremental cost is
30% more than what Ontario spends annually per capita ($3,800) on publicly
funded healthcare. This study is the first to use Ontario administrative data
to estimate healthcare costs for people with chronic pain. The data will be
useful for healthcare planning and will improve the quality of Canadian
cost-utility analyses.
