Health Care Utilization and Direct Costs Prior to Subspecialty Care in Children with Chronic Pain Compared with Other Chronic Childhood Diseases: A Cohort Study
To understand the burden associated with pediatric chronic pain (CP) on the health care system compared with other costly chronic diseases prior to subspecialty care. In this retrospective cohort study, we assessed all-cause health care utilization and direct health care costs associated with pediat...
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| Veröffentlicht in: | The Journal of pediatrics 2024-08, Vol.271, p.114046, Article 114046 |
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| container_title | The Journal of pediatrics |
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| creator | Gerhold, Kerstin Al-Azazi, Saeed El-Matary, Wael Katz, Laurence Y. Lim, Lily S.H. Marks, Seth D. Lix, Lisa M. |
| description | To understand the burden associated with pediatric chronic pain (CP) on the health care system compared with other costly chronic diseases prior to subspecialty care.
In this retrospective cohort study, we assessed all-cause health care utilization and direct health care costs associated with pediatric CP (n = 91) compared with juvenile arthritis (n = 135), inflammatory bowel disease (n = 90), type 1 diabetes (n = 475) or type 2 diabetes (n = 289), anxiety (n = 7193), and controls (n = 273) 2 and 5 years prior to patients entering subspecialty care in Manitoba, Canada. Linked data from physician encounters, emergency department visits, hospitalizations, and prescriptions were extracted from administrative databases. Differences in health care utilization and direct health care costs associated with CP vs the other conditions were tested using negative binomial and zero-inflated negative binomial regression models, respectively.
After adjustment for age at diagnosis, sex, location of residence, and socioeconomic status, CP continued to be associated with the highest number of consulted physicians and subspecialists and the highest number of physician billings compared with all other conditions (P |
| doi_str_mv | 10.1016/j.jpeds.2024.114046 |
| format | Article |
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In this retrospective cohort study, we assessed all-cause health care utilization and direct health care costs associated with pediatric CP (n = 91) compared with juvenile arthritis (n = 135), inflammatory bowel disease (n = 90), type 1 diabetes (n = 475) or type 2 diabetes (n = 289), anxiety (n = 7193), and controls (n = 273) 2 and 5 years prior to patients entering subspecialty care in Manitoba, Canada. Linked data from physician encounters, emergency department visits, hospitalizations, and prescriptions were extracted from administrative databases. Differences in health care utilization and direct health care costs associated with CP vs the other conditions were tested using negative binomial and zero-inflated negative binomial regression models, respectively.
After adjustment for age at diagnosis, sex, location of residence, and socioeconomic status, CP continued to be associated with the highest number of consulted physicians and subspecialists and the highest number of physician billings compared with all other conditions (P < .01, respectively). CP was significantly associated with higher physician costs than juvenile arthritis, inflammatory bowel disease, type 1 diabetes, type 2 diabetes, or controls (P < .01, respectively); anxiety was associated with the highest physician and prescription costs among all cohorts (P < .01, respectively).
Compared with chronic inflammatory and endocrinologic conditions, pediatric CP and anxiety were associated with substantial burden on the health care system prior to subspecialty care, suggesting a need to assess gaps and resources in the management of CP and mental health conditions in the primary care setting.</description><identifier>ISSN: 0022-3476</identifier><identifier>ISSN: 1097-6833</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2024.114046</identifier><identifier>PMID: 38582149</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>adolescents ; anxiety ; children ; inflammatory bowel disease ; juvenile arthritis ; type 1 diabetes ; type 2 diabetes</subject><ispartof>The Journal of pediatrics, 2024-08, Vol.271, p.114046, Article 114046</ispartof><rights>2024 The Author(s)</rights><rights>Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c309t-2cd37b698d1af9edebd7232cdd1ee8ec6eed891673d304fde63125222a60b8073</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022347624001495$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38582149$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gerhold, Kerstin</creatorcontrib><creatorcontrib>Al-Azazi, Saeed</creatorcontrib><creatorcontrib>El-Matary, Wael</creatorcontrib><creatorcontrib>Katz, Laurence Y.</creatorcontrib><creatorcontrib>Lim, Lily S.H.</creatorcontrib><creatorcontrib>Marks, Seth D.</creatorcontrib><creatorcontrib>Lix, Lisa M.</creatorcontrib><title>Health Care Utilization and Direct Costs Prior to Subspecialty Care in Children with Chronic Pain Compared with Other Chronic Childhood Diseases: A Cohort Study</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>To understand the burden associated with pediatric chronic pain (CP) on the health care system compared with other costly chronic diseases prior to subspecialty care.
In this retrospective cohort study, we assessed all-cause health care utilization and direct health care costs associated with pediatric CP (n = 91) compared with juvenile arthritis (n = 135), inflammatory bowel disease (n = 90), type 1 diabetes (n = 475) or type 2 diabetes (n = 289), anxiety (n = 7193), and controls (n = 273) 2 and 5 years prior to patients entering subspecialty care in Manitoba, Canada. Linked data from physician encounters, emergency department visits, hospitalizations, and prescriptions were extracted from administrative databases. Differences in health care utilization and direct health care costs associated with CP vs the other conditions were tested using negative binomial and zero-inflated negative binomial regression models, respectively.
After adjustment for age at diagnosis, sex, location of residence, and socioeconomic status, CP continued to be associated with the highest number of consulted physicians and subspecialists and the highest number of physician billings compared with all other conditions (P < .01, respectively). CP was significantly associated with higher physician costs than juvenile arthritis, inflammatory bowel disease, type 1 diabetes, type 2 diabetes, or controls (P < .01, respectively); anxiety was associated with the highest physician and prescription costs among all cohorts (P < .01, respectively).
Compared with chronic inflammatory and endocrinologic conditions, pediatric CP and anxiety were associated with substantial burden on the health care system prior to subspecialty care, suggesting a need to assess gaps and resources in the management of CP and mental health conditions in the primary care setting.</description><subject>adolescents</subject><subject>anxiety</subject><subject>children</subject><subject>inflammatory bowel disease</subject><subject>juvenile arthritis</subject><subject>type 1 diabetes</subject><subject>type 2 diabetes</subject><issn>0022-3476</issn><issn>1097-6833</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1DAURi0EokPhCZCQl2wyXNupkyCxqMJPkSq1Uunacuw7ikeZONhO0fA0PCrOpHTJypLv-e4n-xDylsGWAZMf9tv9hDZuOfByy1gJpXxGNgyaqpC1EM_JBoDzQpSVPCOvYtwDQFMCvCRnor6oOSubDflzhXpIPW11QHqf3OB-6-T8SPVo6WcX0CTa-pgivQ3OB5o8vZu7OKFxOXdcc26kbe8GG3Ckv9yyrQ9-dIbe6mXkD1Om7Dq6ST2GJ-AU671fuiLqiPEjvcyJ3odE79Jsj6_Ji50eIr55PM_J_dcvP9qr4vrm2_f28rowAppUcGNF1cmmtkzvGrTY2YqLfGsZYo1GItq6YbISVkC5sygF4xeccy2hq6ES5-T9uncK_ueMMamDiwaHQY_o56gEiJLnr6yajIoVNcHHGHCnpuAOOhwVA7WoUXt1UqMWNWpVk1PvHgvm7oD2KfPPRQY-rQDmZz44DCoah6NBe9KgrHf_LfgLGImiWg</recordid><startdate>20240801</startdate><enddate>20240801</enddate><creator>Gerhold, Kerstin</creator><creator>Al-Azazi, Saeed</creator><creator>El-Matary, Wael</creator><creator>Katz, Laurence Y.</creator><creator>Lim, Lily S.H.</creator><creator>Marks, Seth D.</creator><creator>Lix, Lisa M.</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240801</creationdate><title>Health Care Utilization and Direct Costs Prior to Subspecialty Care in Children with Chronic Pain Compared with Other Chronic Childhood Diseases: A Cohort Study</title><author>Gerhold, Kerstin ; Al-Azazi, Saeed ; El-Matary, Wael ; Katz, Laurence Y. ; Lim, Lily S.H. ; Marks, Seth D. ; Lix, Lisa M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c309t-2cd37b698d1af9edebd7232cdd1ee8ec6eed891673d304fde63125222a60b8073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>adolescents</topic><topic>anxiety</topic><topic>children</topic><topic>inflammatory bowel disease</topic><topic>juvenile arthritis</topic><topic>type 1 diabetes</topic><topic>type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gerhold, Kerstin</creatorcontrib><creatorcontrib>Al-Azazi, Saeed</creatorcontrib><creatorcontrib>El-Matary, Wael</creatorcontrib><creatorcontrib>Katz, Laurence Y.</creatorcontrib><creatorcontrib>Lim, Lily S.H.</creatorcontrib><creatorcontrib>Marks, Seth D.</creatorcontrib><creatorcontrib>Lix, Lisa M.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gerhold, Kerstin</au><au>Al-Azazi, Saeed</au><au>El-Matary, Wael</au><au>Katz, Laurence Y.</au><au>Lim, Lily S.H.</au><au>Marks, Seth D.</au><au>Lix, Lisa M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Health Care Utilization and Direct Costs Prior to Subspecialty Care in Children with Chronic Pain Compared with Other Chronic Childhood Diseases: A Cohort Study</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2024-08-01</date><risdate>2024</risdate><volume>271</volume><spage>114046</spage><pages>114046-</pages><artnum>114046</artnum><issn>0022-3476</issn><issn>1097-6833</issn><eissn>1097-6833</eissn><abstract>To understand the burden associated with pediatric chronic pain (CP) on the health care system compared with other costly chronic diseases prior to subspecialty care.
In this retrospective cohort study, we assessed all-cause health care utilization and direct health care costs associated with pediatric CP (n = 91) compared with juvenile arthritis (n = 135), inflammatory bowel disease (n = 90), type 1 diabetes (n = 475) or type 2 diabetes (n = 289), anxiety (n = 7193), and controls (n = 273) 2 and 5 years prior to patients entering subspecialty care in Manitoba, Canada. Linked data from physician encounters, emergency department visits, hospitalizations, and prescriptions were extracted from administrative databases. Differences in health care utilization and direct health care costs associated with CP vs the other conditions were tested using negative binomial and zero-inflated negative binomial regression models, respectively.
After adjustment for age at diagnosis, sex, location of residence, and socioeconomic status, CP continued to be associated with the highest number of consulted physicians and subspecialists and the highest number of physician billings compared with all other conditions (P < .01, respectively). CP was significantly associated with higher physician costs than juvenile arthritis, inflammatory bowel disease, type 1 diabetes, type 2 diabetes, or controls (P < .01, respectively); anxiety was associated with the highest physician and prescription costs among all cohorts (P < .01, respectively).
Compared with chronic inflammatory and endocrinologic conditions, pediatric CP and anxiety were associated with substantial burden on the health care system prior to subspecialty care, suggesting a need to assess gaps and resources in the management of CP and mental health conditions in the primary care setting.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38582149</pmid><doi>10.1016/j.jpeds.2024.114046</doi><oa>free_for_read</oa></addata></record> |
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| source | Elsevier ScienceDirect Journals |
| subjects | adolescents anxiety children inflammatory bowel disease juvenile arthritis type 1 diabetes type 2 diabetes |
| title | Health Care Utilization and Direct Costs Prior to Subspecialty Care in Children with Chronic Pain Compared with Other Chronic Childhood Diseases: A Cohort Study |
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