Presentation (CTI)

OBJECTIVES: To determine pain intensity prevalence and associations of pain intensity and other demographics with healthcare service utilization among United States (US) adults with pain.
METHODS: This cross-sectional analysis utilized 2023 Medical Expenditure Panel Survey data. Community-dwelling US residents who were alive, aged ≥18 years, and experienced pain in 2023 were included. The key independent variable was pain intensity (extreme, quite a bit, moderate, little). Demographics included age, sex, race, Hispanic, marriage, education, employment, insurance, income, smoker, exercise, limitations, physical and mental health, and health conditions. Four healthcare service utilization variables served as dependent variables, categorized as ≥1 or 0 visits: office visits, outpatient visits, inpatient discharges, and emergency room visits. Weighted multivariable logistic regression models were constructed using SAS survey procedures to assess associations between pain intensity and demographics with each of the four healthcare services. All logistic regression assumptions were tested. Significance was set a-priori at 0.05.
RESULTS: The weighted analysis represented 98,504,060 US adults with pain (little pain: weighted n=60,682,157, moderate pain: weighted n=20,035,594, quite a bit of pain: weighted n=13,534,027, extreme pain: weighted n=4,252,282). In multivariable analyses, there was typically no association between pain intensity and healthcare service utilization; one exception was extreme pain being associated with higher odds of emergency room visits (adjusted odds ratio=1.7, 95% confidence interval=1.1-2.7). Examples of demographics associated with healthcare service utilization included older age being associated with higher odds of outpatient visits yet lower odds of emergency room visits. Female sex, white race, and non-Hispanic status were each associated with higher odds of office visits and outpatient visits. Having fair/poor physical health and multiple health conditions were each associated with higher odds of utilizing all four healthcare services.
CONCLUSIONS: The prevalence of at least some pain among US adults approached 100,000,000 in 2023 yet limited associations existed between pain intensity and healthcare service utilization.