Healthcare costs associated with elderly chronic pain patients in primary care

作者：Lazkani Aida^*; Delespierre Tiba; Bauduceau Bernard; Pasquier Florence; Bertin Philippe; Berrut Gilles; Corruble Emmanuelle; Doucet Jean; Falissard Bruno; Forette Francoise; Hanon Olivier; Benattar Zibi Linda; Piedvache Celine; Becquemont Laurent

来源：European Journal of Clinical Pharmacology, 2015, 71(8): 939-947.

DOI：10.1007/s00228-015-1871-6

• Healthcare
• Cost
• Chronic pain
• Elderly patients

Objective This study aimed to estimate the total healthcare costs associated with elderly chronic pain (CP) patients, define cost-related factors in this population, and examine cost evolution over two years.
Method This is an ancillary study from the CP S.AGE subcohort, including non-institutionalized patients aged over 65 suffering from CP. 1190, 1108, 1042, and 950 patients were reviewed with available healthcare data at follow-up visits at 6, 12, 18, and 24 months, respectively. Healthcare components included medical and paramedical visits, medication prescription, and hospitalization.
Result The mean total cost in the first semester was estimated at (sic)2548 +/- (sic)8885 per patient. Hospitalization represented the largest cost component (50 %) followed by paramedical care (24 %), medications (21 %), and medical visits (5 %). Significant cost-associated factors were comorbidity (OR 1.49, 95 % CI 1.35-1.64), dependency in daily activities (OR 1.85, 95 % CI 1.39-2.47), probable depression (OR 1.71, 95 % CI 1.09-2.69), permanent pain (OR 1.48, 95 % CI 1.18-1.86), neuropathic pain (OR 1.94, 95 % CI 1.38-2.73), living alone (OR 1.45, 95 % CI 1.16-1.82), chronic back pain (OR 1.35, 95 % CI 1.07-1.71), and vertebral fracture/compression (OR 1.47, 95 % CI 1.08-2.01). Healthcare costs increased significantly by 48 % (p < 0.0001) during follow-up namely due to hospitalizations. Elevated costs were associated with a higher risk of future hospitalization (OR 1.95, CI 95 % 1.33-2.87).
Conclusion Healthcare costs increased rapidly over time, largely due to hospitalization. Prevention strategies to limit hospitalizations in elderly appear to be the most useful in order to achieve cost savings in the future.

• 出版日期2015-8