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Household income determines access to specialized pediatric chronic pain treatment in Germany

BACKGROUND: Families with lower socioeconomic status (SES) often face problems with gaining access to health care services. Information is scarce on the relationship between SES and health care delivery for children suffering from chronic pain. METHODS: Families presenting to a specialized pain cent...

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Autores principales: Ruhe, Ann-Kristin, Wager, Julia, Hirschfeld, Gerrit, Zernikow, Boris
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4840873/
https://www.ncbi.nlm.nih.gov/pubmed/27102117
http://dx.doi.org/10.1186/s12913-016-1403-9
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author Ruhe, Ann-Kristin
Wager, Julia
Hirschfeld, Gerrit
Zernikow, Boris
author_facet Ruhe, Ann-Kristin
Wager, Julia
Hirschfeld, Gerrit
Zernikow, Boris
author_sort Ruhe, Ann-Kristin
collection PubMed
description BACKGROUND: Families with lower socioeconomic status (SES) often face problems with gaining access to health care services. Information is scarce on the relationship between SES and health care delivery for children suffering from chronic pain. METHODS: Families presenting to a specialized pain center (N = 1,001) provided information on ‘household income, ‘parental education’ and ‘occupation’ to aid the evaluation of their SES. To assess whether the SES of the clinical sample is representative of the general population, it was compared to data from a community sample (N = 14,558). For the clinical sample, travel distance to the clinic was described in relation to the 75 % catchment area. Multiple logistic regression was used to analyze the association between SES and the journey from outside the catchment area. RESULTS: The SES was significantly higher in the clinical sample than in the community sample. Within the clinical sample, the distance traveled to the pain center increased with increasing SES. The 75 % catchment area was 143 miles for families with the highest SES and 78 miles for the lowest SES. ‘Household income’ predicted travel distance (OR 1.32 (1.12–1.56)). Education and occupational status were not significant predictors of travel from outside the catchment area. CONCLUSIONS: In Germany, specialized care for children with chronic pain is subject to disparities in access. Future activities should focus on identifying barriers to access and seeking to prevent inequalities in specialized pediatric health care delivery. Increasing the number of specialized treatment facilities could improve access to specialized pediatric pain treatment, regardless of socioeconomic determinants. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-016-1403-9) contains supplementary material, which is available to authorized users.
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spelling pubmed-48408732016-04-23 Household income determines access to specialized pediatric chronic pain treatment in Germany Ruhe, Ann-Kristin Wager, Julia Hirschfeld, Gerrit Zernikow, Boris BMC Health Serv Res Research Article BACKGROUND: Families with lower socioeconomic status (SES) often face problems with gaining access to health care services. Information is scarce on the relationship between SES and health care delivery for children suffering from chronic pain. METHODS: Families presenting to a specialized pain center (N = 1,001) provided information on ‘household income, ‘parental education’ and ‘occupation’ to aid the evaluation of their SES. To assess whether the SES of the clinical sample is representative of the general population, it was compared to data from a community sample (N = 14,558). For the clinical sample, travel distance to the clinic was described in relation to the 75 % catchment area. Multiple logistic regression was used to analyze the association between SES and the journey from outside the catchment area. RESULTS: The SES was significantly higher in the clinical sample than in the community sample. Within the clinical sample, the distance traveled to the pain center increased with increasing SES. The 75 % catchment area was 143 miles for families with the highest SES and 78 miles for the lowest SES. ‘Household income’ predicted travel distance (OR 1.32 (1.12–1.56)). Education and occupational status were not significant predictors of travel from outside the catchment area. CONCLUSIONS: In Germany, specialized care for children with chronic pain is subject to disparities in access. Future activities should focus on identifying barriers to access and seeking to prevent inequalities in specialized pediatric health care delivery. Increasing the number of specialized treatment facilities could improve access to specialized pediatric pain treatment, regardless of socioeconomic determinants. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-016-1403-9) contains supplementary material, which is available to authorized users. BioMed Central 2016-04-21 /pmc/articles/PMC4840873/ /pubmed/27102117 http://dx.doi.org/10.1186/s12913-016-1403-9 Text en © Ruhe et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Ruhe, Ann-Kristin
Wager, Julia
Hirschfeld, Gerrit
Zernikow, Boris
Household income determines access to specialized pediatric chronic pain treatment in Germany
title Household income determines access to specialized pediatric chronic pain treatment in Germany
title_full Household income determines access to specialized pediatric chronic pain treatment in Germany
title_fullStr Household income determines access to specialized pediatric chronic pain treatment in Germany
title_full_unstemmed Household income determines access to specialized pediatric chronic pain treatment in Germany
title_short Household income determines access to specialized pediatric chronic pain treatment in Germany
title_sort household income determines access to specialized pediatric chronic pain treatment in germany
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4840873/
https://www.ncbi.nlm.nih.gov/pubmed/27102117
http://dx.doi.org/10.1186/s12913-016-1403-9
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