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The Economic Costs of Chronic Pain Among a Cohort of Treatment-Seeking Adolescents in the United States

  • Cornelius B. Groenewald
    Correspondence
    Address reprint requests to Cornelius B. Groenewald, MB, ChB, Anesthesiology and Pain Medicine, Seattle Children's Hospital, M/S MB.11.500.3, 4800 Sand Point Way NE, Seattle, WA 98105.
    Affiliations
    Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington

    Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
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  • Bonnie S. Essner
    Affiliations
    Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
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  • Davene Wright
    Affiliations
    Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington

    Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
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  • Megan D. Fesinmeyer
    Affiliations
    Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
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  • Tonya M. Palermo
    Affiliations
    Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington

    Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington

    Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington

    Department of Psychiatry, University of Washington School of Medicine, Seattle, Washington
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      Highlights

      • This study comprehensively captures costs associated with pediatric chronic pain.
      • Mean per capita costs were $11,797, extrapolated to $19.5 billion for all adolescents in the United States.
      • Costs were concentrated in a small group of participants.
      • The cost of childhood chronic pain presents a substantial economic burden to society.

      Abstract

      The aim of this study was to assess the economic cost of chronic pain among adolescents receiving interdisciplinary pain treatment. Information was gathered from 149 adolescents (ages 10–17) presenting for evaluation and treatment at interdisciplinary pain clinics in the United States. Parents completed a validated measure of family economic attributes, the Client Service Receipt Inventory, to report on health service use and productivity losses due to their child's chronic pain retrospectively over 12 months. Health care costs were calculated by multiplying reported utilization estimates by unit visit costs from the 2010 Medical Expenditure Panel Survey. The estimated mean and median costs per participant were $11,787 and $6,770, respectively. Costs were concentrated in a small group of participants; the top 5% of those patients incurring the highest costs accounted for 30% of total costs, whereas the lower 75% of participants accounted for only 34% of costs. Total costs to society for adolescents with moderate to severe chronic pain were extrapolated to $19.5 billion annually in the United States. The cost of adolescent chronic pain presents a substantial economic burden to families and society. Future research should focus on predictors of increased health services use and costs in adolescents with chronic pain.

      Perspective

      This cost of illness study comprehensively estimates the economic costs of chronic pain in a cohort of treatment-seeking adolescents. The primary driver of costs was direct medical costs followed by productivity losses. Because of its economic impact, policy makers should invest resources in the prevention, diagnosis, and treatment of chronic pediatric pain.

      Key words

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