• Melita J Giummarra, Carolyn A Arnold, and Ben Ben Beck.
• Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
• Pain Med. 2021 Sep 8; 22 (9): 1993-2006.

ObjectiveThis study examined which patient characteristics are associated with traveling further to attend a metropolitan, publicly funded pain management service, and whether travel distance was associated with differences in treatment profile, duration, and percentage of appointments attended.DesignCross-sectional observational cohort study.MethodPatients ≤70 years of age with a single referral between January 2014 and June 2018 who had not died within 12 months of their first appointment and who had a usual place of residence were included (N = 1,684; mean age = 47.2 years; 55.5% female). Travel distance was calculated with the HERE Routing API on the basis of historical travel times for each scheduled appointment.ResultsMedian travel time was 27.5 minutes (Q1, Q3: 12.5, 46.2). Ordinal regression showed that women had 20% lower odds of traveling further, but people who were overweight or obese (odds ratio [OR] = 1.4-2.3), unemployed (OR = 1.27), or taking higher opioid dosages (OR = 1.79-2.82) had higher odds of traveling further. People traveling >60 minutes had fewer treatment minutes (median = 143 minutes) than people living within 15 minutes of the pain clinic (median = 440 minutes), and a smaller proportion of those traveling >60 minutes attended group programs vs. medical appointments only (n = 35, 17.0%) relative to those living within 15 minutes of their destination (n = 184, 32.6%). People living 16-30 minutes from the clinic missed the highest proportion of appointments.ConclusionsAlthough people traveling further for treatment may be seeking predominantly medical treatment, particularly opioid medications, the present findings highlight the need to further explore patient triage and program models of care to ensure that people living with persistent disabling pain can access the same level of care, regardless of where they live.© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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