Chronic pain and use of ambulatory health care.
Chronic pain and use of ambulatory health care.
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慢性疼痛和流动医疗保健的使用。
DOI：
10.1097/00006842-199101000-00006
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发表时间：
1991
影响因子：
3.3
通讯作者：
Saunders,KW
中科院分区：
文献类型：
--
作者：
VonKorff,M;Wagner,EH;Dworkin,SF;Saunders,KW
对1016名成年HMO参与者和242名寻求治疗TMD疼痛的HMO参与者的概率样本中的慢性疼痛状况和医疗保健利用情况进行了评估。因疼痛症状而接触医疗保健服务的可能性：在过去六个月报告背痛、头痛、胸痛、腹痛或颞下颌关节痛的患者中，我们评估了(1)疼痛特征(严重性、持续性、发病近期)和(2)心理困扰是否与最近因每种疼痛症状使用医疗保健的可能性有关。疼痛的严重性、持续性和新近发作通常与最近接触过的医疗保健人员的疼痛症状有关。在控制了疼痛特征后，有疼痛症状的女性并不比男性更有可能报告最近接触过这种症状的医疗保健人员。心理困扰的存在不会增加因个人疼痛症状而接触医疗保健的可能性。然而，心理痛苦的人更有可能报告多个解剖部位的疼痛，并报告最近接触过的五种疼痛症状中的一种或多种(作为一个群体)。慢性疼痛状态和非卧床医疗服务的总使用情况：通过自动数据衡量就诊总次数(无论就诊原因如何)。慢性疼痛状态(总结所有五个解剖部位)显示与卫生保健使用量有适度的相关性。有反复疼痛和严重持续性疼痛且无疼痛相关残疾天数的人以接近人口平均水平的比率使用非卧床护理。严重持续疼痛和与疼痛有关的残疾天数超过7天的人使用医疗保健的比率大大高于人口平均水平。在控制了年龄、性别、自我评估的健康状况和心理困扰后，卫生保健使用量和慢性疼痛之间存在统计学上的显著关联。
Chronic pain status and health care utilization were assessed in a probability sample of 1016 adult HMO enrollees, and among 242 HMO enrollees seeking treatment for Temporomandibular Disorder (TMD) pain. Likelihood of health care contact for a painful symptom: Among persons reporting back pain, headache, chest pain, abdominal pain or temporomandibular pain in the prior six months, we evaluated whether (1) pain characteristics (severity, persistence, recency of onset), and (2) psychological distress were associated with the likelihood of recent use of health care for each pain symptom. Severity, persistence, and recency of onset of pain were generally associated with recent health care contact for a pain symptom. Females with a pain symptom were no more likely than males to report recent health care contact for the symptom after controlling for pain characteristics. The presence of psychological distress did not increase the likelihood of health care contact for individual pain symptoms. However, psychologically distressed persons were more likely to report pain at multiple anatomical sites and to report recent health care contact for one or more of the five pain symptoms (as a group). Chronic pain status and total use of ambulatory health care: Total number of health care visits (irrespective of reason for visit) was measured by automated data. Chronic pain status (summarized across all five anatomical sites) showed a modest correlation with the volume of health care use. Persons with recurrent pain and severe-persistent pain with no pain-related disability days used ambulatory care at rates close to population means. Persons with severe-persistent pain and seven or more pain related disability days used health care at rates substantially above population means. There was a statistically significant association between the volume of health care use and chronic pain after controlling for age, sex, self-rated health status, and psychological distress.