Caudill M, Schnable R, Zuttermeister P, Benson H, Friedman R
Hitchcock Clinic/Matthew Thornton Health Plan, Nashua, New Hampshire.
Clin J Pain. 1991 Dec;7(4):305-10. doi: 10.1097/00002508-199112000-00009.
The treatment of chronic pain is costly and frustrating for the patient, health care provider, and health care system. This is due, in part, to the complexity of pain symptoms which are influenced by behavior patterns, socioeconomic factors, belief systems, and family dynamics as well as by physiological and mechanical components. Assessment of treatment outcomes is often limited to the patient's subjective, multidimensional, self-reports. Outcome measures based on data about return to work or clinic use can provide more objective assessments of intervention benefits. In this study, a 36% reduction in clinic visits in the first year postintervention was found among the 109 patients who participated in an outpatient behavioral medicine program. Decreased clinic use continued in the first 50 patients followed 2 years postintervention. Decreased use projected to an estimated net savings of $12,000 for the first year of the study posttreatment and $23,000 for the second year.
慢性疼痛的治疗对患者、医疗服务提供者和医疗保健系统来说成本高昂且令人沮丧。部分原因在于疼痛症状的复杂性，其受到行为模式、社会经济因素、信仰体系、家庭动态以及生理和机械因素的影响。治疗效果的评估通常局限于患者主观的、多维度的自我报告。基于重返工作或就诊数据的结果指标能够对干预效益提供更客观的评估。在本研究中，参与门诊行为医学项目的109名患者在干预后的第一年门诊就诊次数减少了36%。在干预后随访的前50名患者中，就诊次数持续减少。就诊次数的减少预计在研究治疗后的第一年可节省约12,000美元，第二年可节省23,000美元。
