Frequency and Priority of Pain Patients' Health Care Use
Notice bibliographique
Résumé
BACKGROUND: Increased health care use by pain patients is largely due to conditions other than their identified pain condition, but the kinds of services accounting for increased service use are poorly understood. This study assesses reasons for health care visits of pain patients versus controls, and compares characteristics of pain patients who differ in frequency and priority of service use. METHODS: The study samples included consecutive, primary care back pain (N=807), headache (N=831), and temporomandibular disorder pain (N=372) patients who were interviewed by telephone. Subsequently, age-sex matched controls with a primary care visit in the 6 months before the matched case's pain visit were identified. Over the following 3 years, diagnostic codes for health care visits were classified based on the Oregon Prioritized List of Health Services and case-control differences in major classes of care were compared. Pain patients differing in frequency and priority of service use were compared on measures of pain severity, chronicity, and psychosocial dysfunction. RESULTS: Pain patients' increased health care use was sustained over 3 years. Increased utilization was largely due to symptomatic and ill-defined conditions, lower priority chronic disease, lower and higher priority acute disease, and mental health care. About one-half of the pain patients (vs. one-third of the controls) were frequent health care users. About one-third of the pain patients (vs. one-sixth of the controls) were frequent users who predominantly used medical care for lower priority conditions, and this difference accounted for most of the case-control difference in the prevalence of high users. Pain patients with frequent health care use had more severe pain and greater psychosocial dysfunction than pain patients with less frequent health care use. Among frequent users, pain patients who predominantly used services for lower priority conditions did not differ on measures of pain severity, chronicity, or somatization when compared with frequent users who typically used services for higher priority conditions. CONCLUSIONS: The kind of problems explaining heightened service use of pain patients is more varied and complex than previously understood. These results call for increased attention to the implications of health care providers responding to presenting complaints as if each were a unique problem, without bringing continuity or an integrating perspective to patients' overall experience and management of illness.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,018 | 0,014 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».