Eklund Katarina, Stålnacke Britt-Marie, Enthoven Paul, Zingmark Magnus, Stenberg Gunilla
Department of Community Medicine and Rehabilitation, University of Umeå, Biologihuset Linneus väg 9, Umeå, 90736, Sweden.
Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Physiotherapy, Linköping University, 58183 Linköping, Sweden.
Scand J Pain. 2025 Sep 15;25(1). doi: 10.1515/sjpain-2025-0024. eCollection 2025 Jan 1.
Most patients with chronic pain are identified and managed in primary care (PC). Chronic pain management is challenging, which is manifested by increased healthcare utilization (HCU) in this patient group. The interdisciplinary pain rehabilitation program (IPRP) is the gold standard treatment for patients with chronic pain but is scarcely used in PC. The aim of this study was to evaluate the HCU of patients with chronic pain in PC 1 year before and 1 year after an IPRP by examining the distribution of costs and resources.
This retrospective cohort study combined data from a national pain registry and HCU data from regional administrative registries, including 146 patients who participated in an IPRP in PC. The outcome measure was the number of outpatient healthcare contacts. Costs and the distribution of resources were compared across the two measurement intervals using paired -tests. HCU costs were described from a healthcare provider perspective.
HCU decreased by 16% in the year following IPRP compared to the year before. Costs for outpatient visits dropped by 12% or €434 per participant. Visits to physiotherapists and general practitioners decreased the most, by 31% ( = 0.048) and 23% ( < 0.001) respectively. Visits to nurses, occupational therapists, and psychologists/social workers in turn increased marginally (6%, 5% vs 10%).
IPRP in PC may lead to reduced HCU, freed resources, and streamlined chronic pain management. The study offers valuable insights into expected changes in HCU for chronic pain patients after an IPRP and how these changes may impact daily activities at the PC center.
大多数慢性疼痛患者在初级保健（PC）机构中被识别和管理。慢性疼痛管理具有挑战性，这在该患者群体中表现为医疗保健利用率（HCU）的增加。跨学科疼痛康复计划（IPRP）是慢性疼痛患者的金标准治疗方法，但在初级保健中很少使用。本研究的目的是通过检查成本和资源的分布情况，评估IPRP实施前1年和实施后1年PC机构中慢性疼痛患者的HCU。
这项回顾性队列研究结合了来自国家疼痛登记处的数据和来自地区行政登记处的HCU数据，其中包括146名在PC机构中参加IPRP的患者。结果指标是门诊医疗接触的次数。使用配对t检验比较两个测量区间的成本和资源分布。从医疗服务提供者的角度描述HCU成本。
与IPRP实施前一年相比，实施后一年的HCU下降了16%。每位参与者的门诊就诊费用下降了12%或434欧元。物理治疗师和全科医生的就诊次数下降最多，分别下降了31%（P = 0.048）和23%（P < 0.001）。而护士、职业治疗师以及心理医生/社会工作者的就诊次数则略有增加（分别为6%、5%和10%）。
PC机构中的IPRP可能会降低HCU，释放资源，并简化慢性疼痛管理。该研究为IPRP后慢性疼痛患者的HCU预期变化以及这些变化如何影响PC中心的日常活动提供了有价值的见解。
