Inequalities in access to a tertiary children's chronic pain service: a cross-sectional study

Jay, Matthew A; Howard, Richard

doi:10.1136/archdischild-2015-310280

Cited by 20 publications

(18 citation statements)

References 15 publications

(12 reference statements)

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“…Prior studies have found that socioeconomic factors such as place of residence and type of health insurance coverage may influence referral to a chronic pain clinic, and that a patient's race/ethnicity may affect recognition and management of chronic pain. 11,13,14,18 Therefore, our findings may not be generalizable to patients with chronic pain who were not referred. When examining caregiver-provided reasons for refusal, the most common reasons for not completing an intake visit included using a clinic closer to home, believing that their child did not need a pain clinic, and waiting for their child to undergo further testing.…”

Section: Discussionmentioning

confidence: 87%

“…Recent studies describing the populations that present to chronic pain clinics have found that these patients are primarily female and approximately 12 to 15 years of age. 9-11,13,14 In the United States, these patients are also primarily white. 9,10 A recent analysis at our institution displayed similar demographics among patients with chronic pain.…”

Section: Discussionmentioning

confidence: 99%

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Barriers to Outpatient Pediatric Chronic Pain Clinic Participation Among Referred Patients

Boppana

Miller

Wrona

et al. 2020

Clin Pediatr (Phila)

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Initial clinic evaluation among referred patients and factors limiting treatment initiation are not well characterized. We conducted a retrospective review of referrals to our outpatient pain clinic to identify intake visits and factors associated with treatment initiation among adolescents with chronic pain. We identified adolescents aged 13 to 18 years at the time of referral to clinic (2010-2016). Factors associated with completion of visits were evaluated using logistic regression. Patients who completed visits more frequently had private insurance than public or no insurance ( P = .053). The most common reasons for caregiver decision not to attend the pain clinic included use of another pain clinic, that services were not wanted or no longer needed, and that their child was undergoing further testing. The current study demonstrated that patients with head pain were more likely to complete an intake visit, while there was a trend showing that lack of private insurance decreased this likelihood.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Barriers to Outpatient Pediatric Chronic Pain Clinic Participation Among Referred Patients

Boppana

Miller

Wrona

et al. 2020

Clin Pediatr (Phila)

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“…Adult studies have shown that barriers to accessing specialist services are often lower among more affluent populations, although the National Health Service performs well for equitable care compared with other countries 4. There has been little research into outpatient inequalities in paediatrics in England, although a recent study into a paediatric tertiary chronic pain service similarly found that there were fewer children attending from the most deprived areas than might be expected 5…”

Section: Discussionmentioning

confidence: 99%

How fair is our service? Evaluating access to specialist paediatric care

et al. 2019

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ObjectiveTo assess equity of access to paediatric outpatient clinics in our hospital.Design/settingRetrospective analysis of consecutive accepted referrals to allergy, asthma, epilepsy, general paediatrics, rapid access, chronic fatigue syndrome, diabetes and endocrine outpatient clinics.Patients32 369 new patients, April 2007 to June 2018.ResultsAmong local patients (58.1%) 0.2%–2.5% of patients referred to each clinic lived in the least deprived quintile, and 43.5%–48.4% in the most deprived quintile—similar to inpatient admissions and the local population. Tertiary clinics showed a much higher proportion of patients from the least deprived quintiles (15.9%–26.2%).ConclusionsLocal outpatient referrals broadly reflected the socioeconomic distribution, although not necessarily the distribution of need, of our local population. A relatively high proportion of patients in tertiary clinics were from more affluent postcodes, highlighting the need for referral inequalities to be evaluated across networks or regions.

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“…15 In fact, the domain that is emerging as a significant determinant of both pain and access to treatment is social rather than biological or psychological. Household income and socioeconomic status is a determinant of healthcare utilisation, 16 access to paediatric pain clinics, 17 and to intensive paediatric pain treatment. 18 This is concerning given that lower socioeconomic status has repeatedly been identified as a risk factor for developing pain, 1 independently of child and maternal health status.…”

Section: Cartography In a Changing Landscapementioning

confidence: 99%

Trickle-down healthcare in paediatric chronic pain

McCarthy

Leeuw

2019

British Journal of Anaesthesia

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canal block versus local infiltration analgesia for postoperative pain following anterior cruciate ligament reconstruction: a single centre randomised controlled triple-blinded trial. Br J Anaesth 2019; 123: e343e9 16. Nader A, Kendall MC, Manning DW, et al. Single-dose adductor canal block with local infiltrative analgesia compared with local infiltrate analgesia after total knee arthroplasty: a randomized, double-blind, placebocontrolled trial. Reg Anesth Pain Med 2016; 41: 678e84 17. Sawhney M, Mehdian H, Kashin B, et al. Pain after unilateral total knee arthroplasty: a prospective randomized controlled trial examining the analgesic effectiveness of a combined adductor canal peripheral nerve block with periarticular infiltration versus adductor canal nerve block alone versus periarticular infiltration alone.

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Inequalities in access to a tertiary children's chronic pain service: a cross-sectional study

Cited by 20 publications

References 15 publications

Barriers to Outpatient Pediatric Chronic Pain Clinic Participation Among Referred Patients

Barriers to Outpatient Pediatric Chronic Pain Clinic Participation Among Referred Patients

How fair is our service? Evaluating access to specialist paediatric care

Trickle-down healthcare in paediatric chronic pain

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