The Total Economic Burden Of Pain

Murray J. McAllister created this website because he had concerns for how chronic pain was being understood and managed in the current healthcare system. There is no uniform or consistency in how chronic pain is being treated among healthcare providers. Many providers also correlate chronic pain to a previous orthopedic injury and not from a nervous system related condition. This poses many concerns

Back pain and the perception of pain is a common symptom with multiple causes. According to Porth (2011), at least 2/3’s of people will have one or more

Many experts in healthcare economics point out that chronic medical conditions are directly associated with higher costs (G., 2010). This association is mainly attributed to the high usage of all types of care (Kongstvedt, 2013). Reports show that the number of people suffering with chronic conditions is radically rising and forecasts suggest that the number of American’s with one or more chronic conditions will continue to grow by an estimated 37% between 2000 and 2030 (G., 2010). It is in our patient’s main interest to shift our current focus from treatment for acute conditions to target a better utilization of the recorded 78% of health spending devoted to people with chronic conditions. The new strategic approach is one of developing quality medical care for people with chronic conditions which require ongoing care and care management to improve their health status (Kongstvedt, 2013).

“The total "economic burden" of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement”. -The Centers for Disease Control and Prevention

The selected policy Essence of Care 2010: Benchmarks for the Prevention and Management of Pain, includes the latest benchmarks on the management of pain and its prevention. It presents up to date reviewed views, with the aim to deliver

“The Patient Protection and Affordable Care Act (ACA), informally referred as Obama Care, is a United States federal statue signed into by law by president Barak Obama on March 23, 2010”( Laxmaiah MAnchikanti,2012). Obama care assures they will provide insurance for everyone, with improvements in quality of and reduction in the cost of health care, opponents criticize it as being a massive bureaucracy laden with penalties and taxes that will ultimately eliminate personal medicine and individual practices (Laxmaiah Manchikanti, 2012). Based on these 2 years since 2010, the prognostics for interventional pain management is unclear. They may provide insurance for everyone but with cuts in Medicare to fund Obama Care. Practically limiting expansions on Medicaid

Persistent pain has psychological and social implications for daily life. It can severely limit an individual’s ability to work and be a productive member of society and decreases quality of life. In the face of increasing stigma and barriers to care, patients are struggling to procure the legal medications that alleviate their debilitating pain.

Imaging of musculoskeletal disorders began in the early 1900’s with the invention and utilization of radiography and fluoroscopic equipment (McKinnis, 2014). Evolutions in imaging now allow for clearer digital recorded images of fluoroscopy, radiographs, computed tomography (CT), and magnetic resonance imaging (McKinnis, 2014). From the beginning, imaging has not been an isolated or sole diagnostic tool. The clinician’s expertise in the evaluation process, the comprehensive evaluation and assessment of the patient, documented and reported patient history, associated signs and symptoms, and the additional medical test results along with red flags must be taken into account when considering referral for imaging (Dutton, 2012; McKinnis, 2014). There are several clinical prediction rules and guidelines, which have been created to assist health care providers in managing the utilization and prevention of inappropriate imaging (Dutton, 2012; Gan, Harkey, Hemingway, Hughes, & Duszak, 2016; Gidwani et al., 2016; McKinnis, 2014). Based on the aforementioned information, not all spinal patients will require or should receive spinal imaging.

According to The World Health Organisation (1999), defined pain as an unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Pain is traditionally described as acute or chronic pain. The prevalence of chronic pain (CP) is higher than of acute of pain, as it affects 7.8 million people of all ages in the UK (Chronic Pain Policy Coalition., 2006). The current leading cause of mortality that is accounting for 60% of all deaths is due to chronic diseases and is also a problem as causes an increasing burden on the health care service (World Health Organisation., 2007). CP can affect a person’s quality of life if managed poorly, statistics shows that 25% of people lose their job and 22% leads to depression. (Chronic Pain Policy Coalition.,

In the United States, over 50 million people suffer from chronic pain. The annual cost of chronic pain is around $100 billion. Moreover, 46% of the people suffering from chronic pain lack adequate pain relief (http://www.painfoundation.org/painful.htm).

There is only Shahidi et al 2015’s group who has merged the neurophysiologic-biopsychosocial model of prospectively screening predictors for the development of chronic neck pain through an inception cohort study. Chronic neck pain was operationally defined as chronic idiopathic neck pain that is not trauma related at onset and this includes both chronic recurrent neck pain [“2 or more episodes of neck pain” with in-between periods of full recovery] and chronic persistent neck pain [neck pain with no periods of full recovery] CPNP) as defined by the Neck Pain Task Force in 2008 (Table 1 of Guzman et al 2008). Using over 170 healthy newly hired office workers, Shahidi et al 2015 conducted biopsychosocial-neurophysiologic baseline measurements theorized to be potential predictors of chronic idiopathic neck pain (CINP). These workers were followed up monthly for one year.by the researchers , Of those followed, 35 workers developed CINP. Based on these workers’ baseline measurements, three predictors were identified, namely: cervical extensor endurance, DNIC (or conditioned pain modulation) and depressed mood.

The American Pain Society (APS, 2008), defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (p.1). According to McCaffery (1968), “pain is whatever the experiencing person says it is, existing whenever he says is does”. Pain is a complex, multidimensional experience. It is present in all clinical settings and in many different patient groups. It is one of the main reasons why people seek medical attention. Many health professionals involved in pain control (Lewis, Heitkemper & Dirksen, 2004). In order to measure the level of knowledge of medical and nursing staff about pain management in critical care patients and the economic impact I make

The healthcare system plays a key role in the economic stability of our country, as every year trillions are spent in attempt to combat disease and health issues that plaque humanity. As it makes up a significant amount of the expenditures in the economy, so the costs associated with health care of those in pain from illness and injury, including lost productivity, increased need of assistance in living and also the cost of death in some cases, is important to the economic stability and over all standard of living in our country. The key to economic prosperity is balancing the need for care with the costs of illness to keep as many people healthy and well without breaking the bank of collective society. The costs of healthcare have been increasingly problematic in recent years with so many issues surrounding the current system. With the “total health care spending in the United States expected to reach $4.8 trillion in 2021, up from $2.6 trillion in 2010 and $75 billion in 1970, meaning that health care spending will account for nearly 20 percent of gross domestic product (GDP), or one-fifth of the U.S. economy, by 2021” (Aetna). With this in mind it is apparent that as we look at the trillion-dollar industry of the medical community it seems that it needs to be a major focus of our nation as a whole and with the many issues come many creative solutions. First let us analyze the reasons behind the current cost and the major problems facing this industry and than discus what

A solution to this problem would be for doctors to refuse imaging tests on the first patient visit regarding uncomplicated back pain. Then, if symptoms persist, on the second visit, imaging tests can be done. This simple policy would cut deeply into that 25% and probably save billions of dollars. It may be that prescribing aspirin or some other mild pain reliever should instead be the new first step that doctors take in these kinds of circumstances.

Pain is a basic mechanism in life that helps the body identify that something is wrong or dangerous. Without pain, the body would be severely damaged without realizing it. Pain can become an inconvenience when it spirals out of control; chronic pain, for example, leaves many miserable and unable to enjoy life to its fullest extent even with traditional medical intervention. Around 80% of people report chronic pain in their lifetime (Holtzman & Beggs, 2013). People afflicted by chronic back pain turn to modern medicine for relief, but even these alternatives are not always 100% effective.