Factors associated with persistently high-cost health care utilization for musculoskeletal pain

• DOI: 10.1371/journal.pone.0225125
• Publication Date: 2019-11-11T13:24:56Z
• Authors: Trevor A. Lentz; Jeffrey S. Harman; Nicole M. Marlow; Jason M. Beneciuk; Roger B. Fillingim; Steven Z. George
• Keywords: Back Pain

Background Musculoskeletal pain conditions incur high costs and produce significant personal public health consequences, including disability opioid-related mortality. Persistence of high-cost care utilization for musculoskeletal may help identify system inefficiencies that could limit value care. The objective this study was to factors associated with persistent among individuals seeking pain. Methods This a retrospective cohort Medical Expenditure Panel Survey data (2008–2013) included non-institutionalized, population-based sample condition (n = 12,985). Expenditures over two consecutive years were analyzed from prescribed medicine, office-based medical provider visits, outpatient department emergency room inpatient hospital stays, home visits. Persistent defined as being in the top 15th percentile annual pain-related expenditures 2 years. We used multinomial regression determine which modifiable non-modifiable sociodemographic, health, variables utilization. Results Approximately 35% direct concentrated 4% utilizers. Non-modifiable expenditure group classification age, race, poverty level, geographic region, insurance status, diagnosis type total number diagnoses. Modifiable increased risk higher missed work days, greater interference, use prescription medication pain, while self-reported physical mental lower classification. Conclusions Health delivery models prospectively these potentially improve prone episodes.