title: Patient characteristics and healthcare utilization of a chronic pain population within an integrated healthcare system.
abstract: OBJECTIVE
  We sought to characterize the chronic pain (CP) population and healthcare utilization across types of CP within a community-based healthcare system.
  
  
  METHODS
  Cross-sectional study of electronic health records data from 2012.
  
  
  METHODS
  Patients 18 years or older with at least 2 encounter diagnoses for CP conditions in 2012 were included in the study. Patients were categorized into non-mutually exclusive CP types: arthritis/joint pain, back/cervical pain, neuropathies/neuralgias, headaches/migraines, and unclassified pain.
  
  
  RESULTS
  Of 1,784,114 patients, 120,481 (6.8%) met the criteria for the CP study cohort. Within the cohort, the most common types of CP were arthritis/joint pain (57%), back/cervical pain (49%), and neuropathy/neuralgias (40%). Patients with neuropathies/neuralgias were older than patients with other pain types and had more comorbidities (for neuropathies/neuralgias: mean age, 59 years; Charlson Comorbidity Index score >3, in 28% of patients). Patients with unclassified pain were most likely to be female (82%). Rates of office and emergency department (ED) visits were highest in patients with unclassified pain (5136 events and 209 events per 1000 patients, respectively). Rates of hospitalizations and 30-day hospital readmissions were highest in patients with neuropathies/neuralgias (70 events and 287 events per 1000 patients, respectively). An increased number of CP types was linearly associated with higher rates of office, ED, and hospital visits.
  
  
  CONCLUSIONS
  Based on prevalence, comorbidities, and healthcare utilization, several types of CP, including neuropathies/neuralgias, arthritis/joint pain, and unclassified pain, appear to be most impactful. Health systems can use these findings to target efforts to improve the management of patients with CP, particularly those with multiple pain-related conditions.
authors.affiliation: Palo Alto Medical Foundation Research Institute, 795 El Camino Real, Ames Bldg, Palo Alto, CA 94301. E-mail: romanellir@pamfri.org.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Romanelli
authors.forename: Sonali N
authors.initials: SN
authors.lastname: Shah
authors.forename: Laurence
authors.initials: L
authors.lastname: Ikeda
authors.forename: Braden
authors.initials: B
authors.lastname: Lynch
authors.forename: Terri L
authors.initials: TL
authors.lastname: Craig
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Cappelleri
authors.forename: Trevor
authors.initials: T
authors.lastname: Jukes
authors.forename: Denis
authors.initials: D
authors.lastname: Ishisaka
mesh_terms: D000328:Adult; D000368:Aged; D002140:California; D059350:Chronic Pain / Q000628:therapy*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012307:Risk Factors; D014600:Utilization Review