Thanh Nguyen Xuan, Lopatina Elena, Montgomery Lori S, Robert Magali, Tanguay Robert L, Wasylak Tracy
Strategic Clinical NetworksTM, Alberta Health Services, Edmonton, AB, Canada.
Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Br J Pain. 2024 Apr;18(2):166-175. doi: 10.1177/20494637231209928. Epub 2023 Nov 7.
To compare treated to self-reported prevalence of chronic pain (CP) and to estimate health services utilization (HSU) costs of patients treated for CP in Alberta, Canada.
Patients treated for CP were identified by the physician billing codes of health services for CP from the practitioner claims database in fiscal year 2021/22. The treated prevalence of CP (number of these patients divided by the population) was compared to the self-reported prevalence of CP previously estimated (doi:10.1371/journal.pone.0272638). Costs of patients' HSU included costs for general practitioner (GP), specialist, inpatient, emergency department, outpatient clinic services, and prescription drugs.
The treated prevalence of CP was 6.0% (4.4% among males and 7.8% among females) which was 30% to 41% of the self-reported prevalence. The highest treated prevalence (7.2%) was found in the age group of 18-64 years, followed by age groups of >64 years (7.0%) and <18 years (2.1%). The average cost per patient per year was $5096 ($5878 for males and $4652 for females), of which hospitalizations accounted for 65.0%, outpatient clinic visits 16.4%, ED visits 9.5%, prescription drugs 4.7%, GP visits 3.9%, and specialist visits 0.4%. The total cost of patients with CP for the health system was $1.37 billion (∼7% of total health expenditure), of which males accounted for 41.7% and females for 58.3%.
Our findings suggest that the economic burden of CP is considerable and that many people with self-reported CP do not use the public healthcare services. This can be multifactorial, including lack of availability and accessibility of publicly funded services, people's lack of awareness of available services, lower utilization due to COVID-19 pandemic, and reliance on self-management, private services, and alternative treatments. Further studies are warranted to inform future policies and health system initiatives aiming to reduce the burden of CP and improve lives of people living with it.
比较慢性疼痛（CP）的治疗患病率与自我报告患病率，并估算加拿大艾伯塔省接受CP治疗患者的医疗服务利用（HSU）成本。
通过2021/22财年从业者索赔数据库中CP医疗服务的医生计费代码识别接受CP治疗的患者。将CP的治疗患病率（这些患者的数量除以人口数）与先前估算的CP自我报告患病率进行比较（doi:10.1371/journal.pone.0272638）。患者HSU的成本包括全科医生（GP）、专科医生、住院、急诊科、门诊诊所服务以及处方药的成本。
CP的治疗患病率为6.0%（男性为4.4%，女性为7.8%），为自我报告患病率的30%至41%。18 - 64岁年龄组的治疗患病率最高（7.2%），其次是64岁以上年龄组（7.0%）和18岁以下年龄组（2.1%）。每位患者每年的平均成本为5096美元（男性为5878美元，女性为4652美元），其中住院费用占65.0%，门诊诊所就诊费用占16.4%，急诊科就诊费用占9.5%，处方药费用占4.7%，全科医生就诊费用占3.9%，专科医生就诊费用占0.4%。CP患者给卫生系统带来的总成本为13.7亿美元（约占卫生总支出的7%），其中男性占41.7%，女性占58.3%。
我们的研究结果表明，CP的经济负担相当大，许多自我报告患有CP的人未使用公共医疗服务。这可能是多因素导致的，包括公共资助服务的可及性和可用性不足、人们对可用服务缺乏认识、因新冠疫情导致利用率降低以及对自我管理、私人服务和替代疗法的依赖。有必要进行进一步研究，为未来旨在减轻CP负担并改善CP患者生活的政策和卫生系统举措提供信息。
