Department of Anaesthesia and Pain Management, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
Department of Medical Imaging and Radiation Sciences, Monash University, Clayton, Victoria, Australia.
Pain Med. 2021 Jun 4;22(6):1367-1375. doi: 10.1093/pm/pnaa374.
To provide an update on Australian persistent pain services (number, structure, funding, wait times, activity).
An updated national search was conducted. Of those identified, 74 persistent pain services provided detailed responses between July 2016 and February 2018 (64 adult, seven pediatric, two pelvic pain, and one cancer pain). A similar structure to the original Waiting in Pain (WIP) survey was used, and participants chose online or telephone completion.
Pediatric pain services had more than doubled but remained limited. Adult services had also increased, with a concurrent decrease in median wait times and an increase in the number of new referrals seen each year. Despite this, some lengthy wait times (≥3 years) persisted. Wait times were longest at clinics using public or combined funding models and offering pain management group programs (PMGPs). Although clinical activity had increased, medical staffing had not, suggesting that clinics were operating differently. Privately funded clinics performed more procedures than publicly funded services. Use of PMGPs had increased, but program structure remained diverse.
Specialist pain services have expanded since the original WIP survey, facilitating treatment access for many. However, wait time range suggested that the most disadvantaged individuals still experienced the longest wait times, often far exceeding the recommended 6-month maximum wait. More needs to be done. Numerous developments (e.g., National Strategic Action Plan for Pain Management, health system changes as a result of the COVID-19 pandemic) will continue to influence the delivery of pain services in Australia, and repeated analysis of service structures and wait times will optimize our health system response to the management of this condition.
更新澳大利亚持续性疼痛服务（数量、结构、资金、等待时间、活动）。
进行了一次更新的全国性搜索。在确定的服务中，有 74 家持续性疼痛服务机构在 2016 年 7 月至 2018 年 2 月之间提供了详细的回复（64 家成人、7 家儿科、2 家盆腔疼痛、1 家癌症疼痛）。使用了与原始“等待中的疼痛”（WIP）调查类似的结构，参与者可以选择在线或电话完成。
儿科疼痛服务的数量增加了一倍多，但仍然有限。成人服务也有所增加，同时中位数等待时间缩短，每年新转诊人数增加。尽管如此，一些等待时间仍然很长（≥3 年）。在使用公共或混合资金模式以及提供疼痛管理小组项目（PMGPs）的诊所，等待时间最长。尽管临床活动有所增加，但医疗人员并没有增加，这表明诊所的运作方式不同。私立诊所比公立服务机构进行了更多的手术。PMGPs 的使用有所增加，但项目结构仍然多种多样。
自原始 WIP 调查以来，专科疼痛服务已经扩大，为许多人提供了治疗机会。然而，等待时间范围表明，最弱势的个人仍然经历着最长的等待时间，通常远远超过建议的 6 个月最长等待时间。还需要做更多的工作。许多发展（例如，国家疼痛管理战略行动计划、由于 COVID-19 大流行导致的卫生系统变化）将继续影响澳大利亚疼痛服务的提供，对服务结构和等待时间的反复分析将优化我们的卫生系统对这种疾病管理的反应。
