title: Healthcare Use for Pain in Women Waiting for Gynaecological Surgery.
abstract: Background. Pain while waiting for surgery may increase healthcare utilization (HCU) preoperatively. Objective. Examine the association between preoperative pain and HCU in the year prior to gynecological surgery. Methods. 590 women waiting for surgery in a Canadian tertiary care centre were asked to report on HCU in the year before surgery. Pain was assessed using the Brief Pain Inventory. Results. 33% reported moderate to severe pain intensity and interference in the week before surgery. Sixty-one percent (n = 360) reported a total of 2026 healthcare visits, with 21% (n = 126) reporting six or more visits in the year before surgery. After controlling for covariates, women with moderate to severe (>3/10) pain intensity/interference reported higher odds of overall HCU (≥3 pain-related visits to family doctor or specialist in the past year or ≥1 to emergency/walk-in clinic) compared to women with no or mild pain. Lower body mass index (BMI < 30 versus ≥30) and anxiety and/or depression were associated with emergency department or walk-in visits but not visits to family doctors or specialists. Conclusions. There is a high burden of pain in women awaiting gynecological surgery. Decisions about resource allocation should consider the impact of pain on individuals and the healthcare system.
authors.affiliation: School of Nursing and Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada K7L 3N6.
authors.forename: Sarah
authors.initials: S
authors.lastname: Walker
authors.affiliation: Clinical Research Centre, Kingston General Hospital, Kingston, ON, Canada K7L 2V7; Department of Public Health Sciences, Queen's University, Kingston, ON, Canada K7L 3N6.
authors.forename: Wilma M
authors.initials: WM
authors.lastname: Hopman
authors.affiliation: School of Nursing, Queen's University, Kingston, ON, Canada K7L 3N6.
authors.forename: Meg E
authors.initials: ME
authors.lastname: Carley
authors.affiliation: School of Nursing, Queen's University, Kingston, ON, Canada K7L 3N6.
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Mann
authors.affiliation: Sally Smith Chair in Nursing, School of Nursing and Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada K7L 3N6.
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: VanDenKerkhof
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology* / Q000523:psychology; D010146:Pain / Q000209:etiology* / Q000523:psychology*; D059408:Pain Management; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D055815:Young Adult