Association and attributable hospital costs of chronic pain with relevant geriatric sensitive diseases among the older adults.

IF 3.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Frontiers in Public Health Pub Date : 2026-05-01 eCollection Date: 2026-01-01 DOI:10.3389/fpubh.2026.1828836

Ting Chen, Tianjiao Lan, Kun Tan, Jay Pan, Xiuli Wang

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Abstract

Background: The adverse impacts of chronic pain extend far beyond the physical sensation itself. Chronic pain, an age-related condition, exacerbates geriatric disease burden and drives a central sensitivity-neuropsychiatric complex, necessitating urgent preventive care. This study aimed to investigate the impact of chronic pain on two sensitive diseases, depression, and abilities decline in basic or physical activities (functional limitation) among the inpatients in older adults and explore the attributable hospital costs related to chronic pain.

Method: Participants were sourced from the 2021-2022 Inpatient Discharge Dataset of Sichuan Province, Diagnosis of depression, functional limitation, and chronic pain were identified using International Classification of Diseases, 10th Revision (ICD-10) codes. Logistic regression models were employed to analyze the association between chronic pain and depression and functional limitation. Furthermore, total hospital costs, out-of-pocket costs and length of stay (LOS) were compared between patients (depression and functional limitation) with chronic pain and without using Propensity score matching and Multivariable linear regression.

Results: The analysis included 38,372 and 4,996 inpatients in the depression and functional limitation cohorts, respectively. Chronic pain was significantly associated with both outcomes, yielding odds ratios (ORs) of 1.24 (95% CI: 1.20-1.27) for depression and 1.60 (1.44-1.78) for functional limitation (all p < 0.001), and the effect intensified as the number of painful areas increased. Compared to those without pain, depression patients with chronic pain incurred 68.2% higher total hospital costs ( $β$ =0.52, p < 0.001), 169.1% higher out-of-pocket ( $β$ =0.99, p < 0.001) and 60.0% higher LOS ( $β$ =0.47, p < 0.001). Among patients with Functional limitation, chronic pain also significantly increased log-transformed total costs ( $β$ =0.20), out-of-pocket ( $β$ =0.51), and LOS ( $β$ =0.30), representing relative increases of 22.1, 66.5, and 35.0%, respectively (all p < 0.05). These economic impacts were more pronounced among patients with multi-area pain.

Discussion: This study provides empirical evidence linking chronic pain to deteriorated psychological and physical health among older adults. It highlights the increased burden of the disease and hospitalization, with a particular emphasis on the dangers of multi-area pain. These findings emphasize that prioritizing mental health-focused pain management in outpatient and emergency settings is crucial for preventing avoidable hospitalizations and hospitalization costs in older adults.

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老年人慢性疼痛与相关老年敏感疾病的关联及归因住院费用

背景：慢性疼痛的不良影响远远超出了身体感觉本身。慢性疼痛，一种与年龄相关的疾病，加剧了老年疾病负担，并驱动中枢敏感性-神经精神复合体，需要紧急预防护理。本研究旨在探讨慢性疼痛对老年住院患者两种敏感疾病——抑郁和基本或身体活动能力下降（功能限制）的影响，并探讨与慢性疼痛相关的住院费用归因。方法：参与者来自四川省2021-2022年住院出院数据集，使用国际疾病分类第10版（ICD-10）代码对抑郁症、功能限制和慢性疼痛的诊断进行识别。采用Logistic回归模型分析慢性疼痛、抑郁和功能限制之间的关系。此外，在不使用倾向评分匹配和多变量线性回归的情况下，比较慢性疼痛患者（抑郁和功能限制）的总住院费用、自付费用和住院时间（LOS）。结果：该分析分别纳入了38,372例和4,996例抑郁症和功能限制组的住院患者。慢性疼痛与两种结果显著相关，抑郁症的比值比（or）为1.24 (95% CI: 1.20-1.27)，功能限制的比值比（or）为1.60(1.44-1.78)（所有p β =0.52, p β =0.99, p β =0.47, p β =0.20），自费（β =0.51）和LOS (β =0.30)，分别代表相对增加22.1,66.5和35.0%(所有p 讨论：本研究提供了经验证据，将慢性疼痛与老年人心理和身体健康恶化联系起来。它强调了疾病和住院治疗负担的增加，特别强调了多区域疼痛的危险。这些发现强调，在门诊和急诊环境中优先考虑以精神健康为重点的疼痛管理，对于预防老年人可避免的住院和住院费用至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Public Health Medicine-Public Health, Environmental and Occupational Health

CiteScore

4.80

自引率

7.70%

发文量

4469

审稿时长

14 weeks

期刊介绍： Frontiers in Public Health is a multidisciplinary open-access journal which publishes rigorously peer-reviewed research and is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians, policy makers and the public worldwide. The journal aims at overcoming current fragmentation in research and publication, promoting consistency in pursuing relevant scientific themes, and supporting finding dissemination and translation into practice. Frontiers in Public Health is organized into Specialty Sections that cover different areas of research in the field. Please refer to the author guidelines for details on article types and the submission process.