title: Chronic pain and health care spending: an analysis of longitudinal data from the Medical Expenditure Panel Survey.
abstract: OBJECTIVE
  To estimate average incremental health care expenditures associated with chronic pain by health care service category, expanding on prior research that focused on specific pain conditions instead of general pain, excluded low levels of pain, or did not incorporate pain duration.
  
  
  METHODS
  Medical Expenditure Panel Survey (MEPS) data (2008-2011; N = 26,671).
  
  
  METHODS
  Differences in annual expenditures for adults at different levels of pain that interferes with normal work, as measured by the SF-12, were estimated using recycled predictions from two-part logit-generalized linear regression models.
  
  
  RESULTS
  "A little bit" of chronic pain-related interference was associated with a $2,498 increase in total adjusted expenditures over no pain interference (p < .0001) and a $1,008 increase over nonchronic pain interference (p = .0001). Moderate and severe chronic pain-related interference was associated with a $3,707 and $5,804 increase in expenditures over no pain interference and a $2,218 and $4,315 increase over nonchronic interference, respectively (p < .0001). Expenditure increases were most pronounced for inpatient and hospital outpatient expenditures compared to other types of health care expenditures.
  
  
  CONCLUSIONS
  Chronic pain limitations are associated with higher health care expenditures. Results underscore the substantial cost of pain to the health care system.
authors.affiliation: Department of Health Management and Policy, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX.|Department of Behavioral Health Analytics, Magellan Health, Inc., Columbia, MD.
authors.forename: Erica L
authors.initials: EL
authors.lastname: Stockbridge
authors.affiliation: Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX.
authors.forename: Sumihiro
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Center for Health Innovation, The New York Academy of Medicine, New York, NY.|Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.|Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.
authors.forename: José A
authors.initials: JA
authors.lastname: Pagán
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D059350:Chronic Pain / Q000191:economics*; D015897:Comorbidity; D005260:Female; D015438:Health Behavior; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Pain; chronic pain; health care costs; health services; medical expenditures