Maeng Daniel D, Baylor Kelly, Bulger John B, Han John J
Department of Epidemiology and Health Services Research, Geisinger, Danville, PA, USA,
J Pain Res. 2018 Oct 18;11:2375-2383. doi: 10.2147/JPR.S177231. eCollection 2018.
Chronic pain is a highly prevalent and costly condition with few proven treatment options. Since 2014, Geisinger's Department of Pain Medicine has implemented the Multidisciplinary Pain Program (MPP), which consists of a 3-day educational seminar followed by 12 months of comprehensive care. This study examines the impact of MPP on care utilization and cost between 2014 and 2016.
A retrospective health insurance claims data analysis covering a 3-year period between January 2013 and December 2016. Among all patients referred to MPP during the period, a subset of those who were Geisinger Health Plan (GHP) members was identified (113 patients). Those who were GHP members and were referred to MPP after December 2016 served as the contemporaneous comparison group (69 patients). GHP's claims data for the corresponding period were analyzed on a per-member-per-month (PMPM) basis.
MPP was associated with US$754 PMPM reduction in total cost of care including prescription drug costs (=0.014) and US$846 reduction in total medical cost excluding prescription drugs (=0.006). These cost savings were attributable to reductions in utilization of high-end diagnostic imaging (52 per-1,000 members-per month; =0.015) and acute inpatient admissions (20 per-1,000 members-per month; =0.086).
Patients enrolled in MPP were less likely to use expensive diagnostic imaging and experienced fewer hospitalizations, resulting in total cost of care savings. These findings are consistent with the expectation that MPP improves health outcomes among patients suffering from chronic pain.
慢性疼痛是一种非常普遍且成本高昂的疾病，经证实的治疗选择很少。自2014年以来，盖辛格疼痛医学部实施了多学科疼痛项目（MPP），该项目包括一个为期3天的教育研讨会，随后是12个月的全面护理。本研究考察了2014年至2016年间MPP对医疗服务利用和成本的影响。
对2013年1月至2016年12月这3年期间的医疗保险理赔数据分析。在该期间所有转诊至MPP的患者中，确定了一部分盖辛格健康计划（GHP）成员（113名患者）。将2016年12月后转诊至MPP的GHP成员作为同期对照组（69名患者）。按成员每月（PMPM）对GHP同期的理赔数据进行分析。
MPP使包括处方药成本在内的总护理成本每月每名成员降低754美元（=0.014），不包括处方药的总医疗成本降低846美元（=0.006）。这些成本节约归因于高端诊断成像的使用减少（每月每1000名成员52次；=0.015）和急性住院人数减少（每月每1000名成员20次；=0.086）。
参加MPP的患者使用昂贵诊断成像的可能性较小，住院次数较少，从而节省了总护理成本。这些发现与MPP改善慢性疼痛患者健康结局的预期一致。
