Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Nov 8:11:2741-2759.
doi: 10.2147/JPR.S175090. eCollection 2018.

Just how much does it cost? A cost study of chronic pain following cardiac surgery

Jason Robert Guertin  1   2 , M Gabrielle Pagé  3   4 , Jean-Éric Tarride  5 , Denis Talbot  1   2 , Judy Watt-Watson  6 , Manon Choinière  3   4
Affiliations

Just how much does it cost? A cost study of chronic pain following cardiac surgery

Jason Robert Guertin et al. J Pain Res. .

Abstract

Objective: The study objective was to determine use of pain-related health care resources and associated direct and indirect costs over a two-year period in cardiac surgery patients who developed chronic post-surgical pain (CPSP).

Methods: This multicentric observational prospective study recruited patients prior to cardiac surgery; these patients completed research assistant-administered questionnaires on pain and psychological characteristics at 6, 12 and 24 months post-operatively. Patients reporting CPSP also completed a one-month pain care record (PCR) (self-report diary) at each follow-up. Data were analyzed using descriptive statistics, multivariable logistic regression models, and generalized linear models with log link and gamma family adjusting for sociodemographic and pain intensity.

Results: Out of 1,247 patients, 18%, 13%, and 9% reported experiencing CPSP at 6, 12, and 24 months, respectively. Between 16% and 28% of CPSP patients reported utilizing health care resources for their pain over the follow-up period. Among all CPSP patients, mean monthly pain-related costs were CAN$207 at 6 months and significantly decreased thereafter. More severe pain and greater levels of pain catastrophizing were the most consistent predictors of health care utilization and costs.

Discussion: Health care costs associated with early management of CPSP after cardiac surgery seem attributable to a minority of patients and decrease over time for most of them. Results are novel in that they document for the first time the economic burden of CPSP in this population of patients. Longer follow-up time that would capture severe cases of CPSP as well as examination of costs associated with other surgical populations are warranted.

Summary: Economic burden of chronic post-surgical pain may be substantial but few patients utilize resources. Health utilization and costs are associated with pain and psychological characteristics.

Keywords: CARD-PAIN; cardiac surgery; chronic post-surgical pain; costs; health care utilization.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study flow diagram.
See this image and copyright information in PMC

References

    1. Andersen RM, Davidson PL. Improving access to care in America: Individual and contextual indicators. In: Andersen R, Rice T, Kominski E, editors. Changing the US Health Care System: Key Issues in Health Services, Policy, and Management. San Francisco: Jossey-Bass; 2001. pp. 3–30.
    1. Antaky E, Lalonde L, Schnitzer ME, et al. Identifying heavy health care users among primary care patients with chronic non-cancer pain. Can J Pain. 2017;1(1):22–36. - PMC - PubMed
    1. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287–333. - PubMed
    1. Burns LC, Ritvo SE, Ferguson MK, Clarke H, Seltzer Z, Katz J. Pain catastrophizing as a risk factor for chronic pain after total knee arthro-plasty: a systematic review. J Pain Res. 2015;8:21–32. - PMC - PubMed
    1. Canadian Automobile Association [webpage on the Internet] CAA Driving Costs Calculator. 2017. [Accessed March 9, 2017]. Available from: http://caa.ca/car_costs.

LinkOut - more resources