VA Healthcare Costs of a Collaborative Intervention for Chronic Pain in Primary Care
Bibliographic Data
| ID | 9099522 |
|---|---|
| Authors | Kathryn C Dickinson, Kathryn Dickinson (Portland VA Medical Center, corresponding author), Rajiv Sharma (0000-0002-7480-7427, Portland State University, corresponding author), Jonathan P Duckart (Portland VA Medical Center, corresponding author), Kathryn Corson (Oregon Health & Science University, corresponding author), Martha S Gerrity, Martha Gerrity (0000-0002-8772-4591, Portland VA Medical Center, corresponding author), Steven K Dobscha (0000-0002-1539-8950, Portland VA Medical Center, corresponding author) |
| Year | 2010 |
| Volume | 48 |
| Issue | 1 |
| Pages | 38-44 |
| Publication date | 2010-01-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0b013e3181bd49e2 |
| PMID | 19952802 |
| OpenAlex | W2002230050 |
| Language | EN |
| References cited | 43 |
BACKGROUND: Chronic pain is costly to individuals and the healthcare system, and is often undertreated. Collaborative care models show promise for improving treatment of patients with chronic pain. The objectives of this article are to report the incremental benefit and incremental health services costs of a collaborative intervention for chronic pain from a veterans affairs (VA) healthcare perspective. METHODS: Data on VA treatment costs incurred by participants were obtained from the VA's Decision Support System for all utilization except certain intervention activities which were tracked in a separate database. Outcome data were from a cluster-randomized trial of a collaborative intervention for chronic pain among 401 primary care patients at a VA medical center. Intervention group participants received assessments and care management; stepped-care components were offered to patients requiring more specialized care. The main outcome measure was pain disability-free days (PDFDs), calculated from Roland-Morris Disability Questionnaire scores. RESULTS: Participants in the intervention group experienced an average of 16 additional PDFDs over the 12-month follow-up window as compared with usual care participants; this came at an adjusted incremental cost of $364 per PDFD for a typical participant. Important predictors of costs were baseline medical comorbidities, depression severity, and prior year's treatment costs. CONCLUSIONS: This collaborative intervention resulted in more pain disability-free days and was more expensive than usual care. Further research is necessary to identify if the intervention is more cost-effective for some patient subgroups and to learn whether pain improvements and higher costs persist after the intervention has ended
Chronic pain · Collaborative Care · Family medicine · Health care · Intervention (counseling) · Physical therapy · Primary care · Randomized controlled trial · Veterans Affairs · Medicine · Musculoskeletal pain and rehabilitation · Nursing · Opioid Use Disorder Treatment · Pain Management and Opioid Use
Improving Primary Care for Patients With Chronic Illness
Improving Primary Care for Patients With Chronic Illness
Grading the severity of chronic pain
Depression and Pain Comorbidity
Methods for Analyzing Health Care Utilization and Costs
Smearing Estimate
Impact of Disseminating Quality Improvement Programs for Depression in Managed Primary Care
The PHQ-9
Treatment Costs, Cost Offset, and Cost-Effectiveness of Collaborative Management of Depression
Patient Attitudes, Insurance, and Other Determinants of Self-Referral to Medical and Chiropractic Physicians
Use of the Decision Support System for VA Cost-Effectiveness Research
Construction and Characteristics of the RxRisk-V
Changing Provider Behavior
Evaluation of Index and Profile Measures of Health Status in a Randomized Controlled Trial
| Citation velocity | historical |
|---|---|
| Highly cited | No |