• Clin J Pain · Sep 2017

    Health Care Utilization and Cost in Children and Adolescents with Chronic Pain: Analysis of Health Care Claims Data One Year Before and After Intensive Interdisciplinary Pain Treatment.

    • Ann-Kristin Ruhe, Michael Frosch, Julia Wager, Roland Linder, Ingo Pfenning, Dirk Sauerland, and Boris Zernikow.
    • *German Paediatric Pain Centre, Children's and Adolescents' Hospital, and Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health-School of Medicine ‡Institutional Economics and Health Policy, Witten/Herdecke University, Germany †Scientific Institute of the TK (Techniker Krankenkasse) for Benefit and Efficiency in Health Care, Hamburg, Germany.
    • Clin J Pain. 2017 Sep 1; 33 (9): 767-776.

    ObjectivesThe aim of this study was to analyze changes in health care utilization and cost among a sample of highly impaired children and adolescents who sought a 3-week intensive interdisciplinary pain treatment (IIPT).Materials And MethodsClaims data from 7 statutory health insurance companies were analyzed for 65 children and adolescents who sought IIPT at the German Paediatric Pain Centre. The annual health care utilization and cost were determined for the following 4 areas: outpatient care, inpatient care, medications, and remedies and aids. We analyzed the changes in resource utilization in the year before (pre_1 y) IIPT and in the subsequent year (post_1 y).ResultsWithin the first year after IIPT, overall health care costs did not decrease significantly. However, the pattern of health care utilization changed. First, significantly more children and adolescents started outpatient psychotherapy (P=0.001). Second, the number of hospitalized children decreased significantly from 1-year pre to 1-year post (P=0.001). Accordingly, there were significantly fewer hospitalizations for primary chronic pain disorders at 1-year post (P<0.001). The prescription of nonopioids, co-analgesics and opioids was significantly reduced from 1-year pre to 1-year post (all P<0.013).DiscussionThe present results indicate that the health care costs of children and adolescents with severe chronic pain disorders do not significantly decrease 1 year after IIPT; however, the treatment becomes more goal-focused. Differential diagnosis measures and nonindicated therapeutic interventions decreased, and more indicated interventions, such as psychotherapy, were used. Future research is needed to investigate the economic long-term changes after IIPT.

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