Correlation of self-reported pain severity and healthcare expenditures in older United States adults

Abstract

Objectives: Healthcare expenditures of older United States (US) adults with different pain severity levels are unknown, yet important to investigate given the increasing prevalence of pain in this population. This study assessed the correlation of healthcare expenditures among older US adults with different pain severity levels, hypothesizing that expenditures would increase as pain severity increased. Methods: This retrospective cross-sectional database study used 2018 Medical Expenditure Panel Survey data and included US adults aged ≥50 with self-reported pain in the past four weeks and positive healthcare costs. Adjusted linear regression models with logarithmically transformed expenditure data compared differences in: total; office-based; outpatient; emergency room; inpatient; other; and prescription medication expenditures, between those with little, moderate, quite a bit, and extreme pain. Analyses were weighted appropriately to account for the complex MEPS design and to obtain nationally representative estimates. The a priori alpha level for statistical significance was 0.05. Results: The weighted study population included 57,134,711 US adults aged ≥50 with self- reported pain (little=53.1%, moderate=21.6%, quite-a-bit=18.5%, extreme=6.8%). In adjusted linear regression models, compared to little pain, extreme pain had the greatest increase in costs, followed by quite a bit pain and moderate pain, for total, office-based, and prescription medication costs. For instance, compared to little pain, total healthcare costs were 78% greater for those with extreme pain, 51% greater for quite a bit pain, and 37% greater for moderate pain. However, this pattern was not observed for outpatient, emergency room, inpatient, and other costs, where ≥1 comparison for each cost category was not statistically significant. Conclusions: This study found total healthcare costs increased as pain severity increased, yet this was not always the case when analyzing subcategories of healthcare costs. Further research is needed to investigate why some types of healthcare costs are greater with increasing pain severity, yet others are not.