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Changes in Health Care Utilization for Pediatric Patients Treated at a Specialized Outpatient Pain Clinic. WMJ 2019 Dec;118(4):164-168

Date

01/25/2020

Pubmed ID

31978284

Scopus ID

2-s2.0-85078228471

Abstract

INTRODUCTION: Pediatric pain clinics may be the most efficacious way to manage chronic and recurrent pain in children and adolescents, but families often rely heavily on nonspecialized care, such as the emergency department (ED). Health care utilization patterns for pediatric chronic pain have not been fully explored, particularly the patient-level factors that may contribute to underutilization or overutilization of certain services.

OBJECTIVES: To identify health care utilization patterns before and after treatment at a pediatric pain clinic and the associations by primary diagnosis and patient sociodemographics.

METHODS: Data were obtained for all pediatric patients with an initial visit at an outpatient pediatric pain clinic between 2005 and 2009. Individual-level data included patient demographics, insurance type, and diagnosis at first pain clinic visit. Rate of health care system utilization 3 months before and after the initial pain clinic visit was quantified. Health care utilization rates before and after the initial visit to the pain clinic were compared using Wilcoxon signed-rank test.

RESULTS: Eight hundred twenty-six pediatric pain clinic patients were included. Overall, there were significant decreases in ED utilization (P < 0.001) and increases in outpatient service utilization (P < 0.001) after the initial pain clinic visit. Similar patterns were noted for patients by diagnosis (headache, musculoskeletal, or abdominal pain diagnoses) and among those who were female, white, 15 to 18 years old, privately insured, middle- or high-income (P < 0.05).

CONCLUSIONS: Visits to an outpatient pediatric pain clinic were associated with shifts in health care utilization patterns. Important changes were an overall decrease in emergency visits and an increase in outpatient visits.

Author List

Spector A, Brazauskas R, Hainsworth K, Hoffman GM, Weisman S, Cassidy LD

Authors

Ruta Brazauskas PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Laura Cassidy PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Keri Hainsworth PhD Associate Professor in the Anesthesiology department at Medical College of Wisconsin
George M. Hoffman MD Chief, Professor in the Anesthesiology department at Medical College of Wisconsin
Steven J. Weisman MD Professor in the Anesthesiology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Ambulatory Care Facilities
Child
Female
Humans
Male
Pain Clinics
Pain Management
Utilization Review
Wisconsin
jenkins-FCD Prod-484 8aa07fc50b7f6d102f3dda2f4c7056ff84294d1d