The association between pediatric chronic pain clinic attendance and health care utilization: A retrospective analysis

BACKGROUND: Pediatric chronic pain is common, disabling, and costly. Children with chronic pain have high health care utilization in that they are seen by multiple health care providers, have frequent emergency room visits, and require many diagnostic tests. Pediatric health care utilization relating to direct health care services and associated costs of attendance at chronic pain clinics in Canada has not been well described. AIM: The purpose of this project was to analyze the cost of physician services for individuals attending an interprofessional pediatric chronic pain clinic over an 8-year span including years before, during, and after treatment. METHODS: Physician claims were extracted from the Ontario Health Insurance Plan (OHIP) Claims History Database and retrospectively reviewed over 8 fiscal years for 100 new patients seen at the Chronic Pain Clinic at the Hospital for Sick Children. The utilization metrics analyzed included physician consultations and follow-up appointments, emergency room visits, lab tests, and diagnostic imaging. These data reflected 2 years prior to the first chronic pain clinic appointment, year of initial appointment, and five subsequent years. RESULTS: Health care utilization based on OHIP claims related to physician services and cost analysis showed an increase during the 2 years prior to first chronic pain clinic appointment, a decrease during the year of initial appointment, and a further decrease over the subsequent 5 years. CONCLUSIONS: Further prospective research is required to establish whether attendance at the chronic pain clinic caused the reduction in health care services and costs and, if so, to identify the effective components of treatment.