Children's Hospital Los Angeles, University of Southern California University Center of Excellence for Developmental Disabilities, Department of Anesthesiology Critical Care Medicine, Los Angeles, California.
Children's Hospital Los Angeles, University of Southern California University Center of Excellence for Developmental Disabilities, Department of Anesthesiology Critical Care Medicine, Los Angeles, California; Keck School of Medicine, University of Southern California, Departments of Anesthesiology, Pediatrics, and Psychiatry & Behavioral Sciences, Los Angeles, California.
J Pain. 2018 Feb;19(2):158-165. doi: 10.1016/j.jpain.2017.09.008. Epub 2017 Oct 17.
Chronic pain is characterized by high rates of functional impairment, health care utilization, and associated costs. Research supports the use of comprehensive, interdisciplinary treatment approaches. However, many hospitals hesitate to offer this full range of services, especially to Medi-Cal/Medicaid patients whose services are reimbursed at low rates. This cost analysis examines the effect on hospital and insurance costs of patients' enrollment in an interdisciplinary pediatric pain clinic, which includes medication management, psychotherapy, biofeedback, acupuncture, and massage. Retrospective hospital billing data (inpatient/emergency department/outpatient visits, and associated costs/reimbursement) from 191 consecutively enrolled Medi-Cal/Medicaid pediatric patients with chronic pain were used to compare 1-year costs before initiating pain clinic services with costs 1 year after. Pain clinic patients had significantly fewer emergency department visits, fewer inpatient stays, and lower associated billing, compared with the year before without interdisciplinary pain management services. Cost savings to the hospital of $36,228 per patient per year and to insurance of $11,482 per patient per year were found even after pain clinic service billing was included. Analyses of pre-pain clinic costs indicate that these cost reductions were likely because of clinic participation. Findings provide economic support for the use of interdisciplinary care to treat pediatric chronic pain on an outpatient basis from a hospital and insurance perspective.
This article presents a cost analysis of an interdisciplinary pediatric pain outpatient clinic. Findings support the incorporation of a comprehensive treatment approach that can reduce costs from a hospital and insurance perspective over the course of just 1 year.
慢性疼痛的特点是功能障碍、医疗保健利用和相关成本的高发生率。研究支持使用综合的、跨学科的治疗方法。然而，许多医院不愿提供全方位的服务，尤其是 Medi-Cal/Medicaid 患者，他们的服务报销率很低。本成本分析考察了患者参加跨学科儿科疼痛诊所对医院和保险成本的影响，该诊所包括药物管理、心理治疗、生物反馈、针灸和按摩。使用 191 名连续入组的 Medi-Cal/Medicaid 慢性疼痛儿科患者的回顾性医院计费数据（住院/急诊/门诊就诊次数及相关费用/报销），比较了开始疼痛诊所服务前 1 年的费用和 1 年后的费用。与没有跨学科疼痛管理服务的前一年相比，疼痛诊所患者的急诊就诊次数、住院次数和相关计费明显减少。即使包括疼痛诊所服务计费，医院每年每位患者可节省 36228 美元，保险每年每位患者可节省 11482 美元。对疼痛诊所前的费用分析表明，这些成本的降低可能是因为参与了诊所。研究结果从医院和保险的角度为在门诊基础上使用跨学科护理治疗儿科慢性疼痛提供了经济支持。
本文对跨学科儿科疼痛门诊进行了成本分析。研究结果支持采用综合治疗方法，在短短 1 年内从医院和保险的角度降低成本。
