Abd-Elsayed Alaa, Jin Max Y
Department of Anesthesiology, University of Wisconsin, Madison, WI, 53711, USA.
Curr Pain Headache Rep. 2025 Jan 13;29(1):24. doi: 10.1007/s11916-025-01359-2.
The number of facilities and physicians that offer pain management services has grown significantly since the 1970s. Despite the rise in prevalence of individuals with chronic pain during that time, interventional pain physicians remain underutilized. One reason why this may be the case is a large number of patients are referred directly to surgical specialists prior to being seen by an interventional pain physician. With the rising cost of healthcare, a shift away from surgical specialists and towards pain specialists as part of a multidisciplinary care team may help reduce the cost of care for chronic pain patients.
Through comparing the costs for patients with various types of chronic back pain, it was found that those who were treated by a pain physician rather than a surgeon saved up to over $8000 USD. Despite the cost benefits, it is important to recognize that healthcare disparities still exist which prevent patients from accessing interventional pain physicians. These disparities include patient location and insurance coverage. Overall, the treatment paradigm should start with non-invasive treatments, followed by minimally invasive procedures, with surgical interventions reserved as a last resort for when less invasive measures fail. Early incorporation of a multidisciplinary care team that includes chronic pain management services is critical for providing appropriate and cost-effective patient care.
自20世纪70年代以来，提供疼痛管理服务的机构和医生数量显著增加。尽管在此期间慢性疼痛患者的患病率有所上升，但介入疼痛科医生的利用率仍然较低。出现这种情况的一个原因是，大量患者在看介入疼痛科医生之前就被直接转诊给了外科专家。随着医疗保健成本的上升，作为多学科护理团队的一部分，从外科专家转向疼痛专家可能有助于降低慢性疼痛患者的护理成本。
通过比较各类慢性背痛患者的治疗费用，发现由疼痛科医生而非外科医生治疗的患者节省了高达8000多美元。尽管有成本效益，但必须认识到，医疗保健差距仍然存在，这阻碍了患者获得介入疼痛科医生的治疗。这些差距包括患者所在地和保险覆盖范围。总体而言，治疗模式应从非侵入性治疗开始，然后是微创手术，手术干预作为侵入性较小的措施失败时的最后手段。尽早纳入包括慢性疼痛管理服务在内的多学科护理团队对于提供适当且具有成本效益的患者护理至关重要。
