Online Program

331724
Utilization of interventions for the treatment of pain among Medicare beneficiaries


Monday, November 2, 2015

Jon Mills, MBA, College of Public Health and Health Professionals, Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL
Sarah Bauer, MPH, College of Public Health and Health Professionals, Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL
Trevor Lentz, PT, Department of Physical Therapy, University of Florida, Gainesville, FL
Heidi Kinsell, PhD(c), College of Public Health and Health Professionals, Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL
Ivana Vaughn, MPH, College of Public Health and Health Professionals, Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL
Steven George, PT, PhD, Department of Physical Therapy, University of Florida, Gainesville, FL
Roger Fillingim, PhD, Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL
Jeffrey Harman, PhD, College of Public Health and Health Professions, Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, FL
background: Little is known about Medicare population characteristics and treatment utilization patterns among beneficiaries diagnosed with pain. The aim of this study was to identify demographic factors associated with pain diagnoses and pharmacological and nonpharmacological treatment approaches for pain. methods: We conducted an observational study using the Medicare Current Beneficiary Survey Cost and Use Files (MCBS) from 2006 to 2010. Patients were identified as having a pain condition using the primary ICD-9 code from physician claim files. Patients were categorized into one of five pain categories. Characteristics of patients diagnosed with pain and frequencies of interventions used are reported using weighted analysis. results: From 2006-2010, 59% of the American Indian sample were diagnosed with a pain condition compared to only 53% of Whites and 48% of Black or African Americans. Nearly twice as many women sought treatment for pain compared to men. Chiropractic manipulation comprised nearly 70% of interventions for low back pain,  but interventions were far more varied for extremity, radicular, osteoarthritic and neuropathic pain. Across the five pain categories, opioids, muscle relaxants and anti-epileptics were the most commonly prescribed medicines  for pain control. conclusions: Pain is a major source of disability and large driver of utilization and expenditures for Medicare patients. Larger variation in treatment utilization for extremity, radicular, osteoarthritic or neuropathic conditions compared to back pain indicates potential uncertainty in best practices for these conditions.  Future research should compare the cost-effectiveness of different treatments for specific conditions in these pain categories.

Learning Areas:

Administer health education strategies, interventions and programs
Chronic disease management and prevention
Other professions or practice related to public health

Learning Objectives:
Describe demographic factors associated with pain diagnoses among Medicare beneficiaries. Identify pharmacological and nonpharmacological treatment approaches for pain.

Keyword(s): Medicare, Medical Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been co-investigator on this project, as well as other funded studies examining the role of psychosocial and contextual factors in the development and maintenance of musculoskeletal pain . My interests include the comparative effectiveness of common treatment approaches for musculoskeletal pain.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.