Ability of the Pain Disability Questionnaire in Predicting Healthcare Utilization
Rankin, McKenna Blair
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BACKGROUND: Chronic pain is one of the most expensive and prevalent healthcare problems in the United States. It affects not only the individual but also society as a whole. The Biopsychosocial Model of chronic pain is the standard model for understanding and treating the pain experience. As such, it is important to have accurate ways of predicting healthcare outcomes for the chronic pain population. Prior research has evaluated the predictive abilities of health outcome measures and healthcare utilization. However, only one study to our knowledge has evaluated the Pain Disability Questionnaire’s (PDQ) ability to predict healthcare utilization. SUBJECTS: The current study consisted of 50 [Mage = 54.76 (12.41) years] adult patients diagnosed with chronic pain who completed an interdisciplinary treatment program at the Eugene McDermott Center for Pain Management. METHOD: The PDQ was administered at baseline and total health care cost was obtained at three-month follow-up. Participants were placed in either the high or low health care cost group depending on how they compared to a national average estimate for chronic pain patients. Logistic and linear regression modeling, as well as receiver operator characteristic analyses were used to evaluate the predictive ability of the PDQ in determining healthcare utilization cost at a three-month follow-up time point. RESULTS: The logistic regression analysis indicated the PDQ accurately placed participants in the respective high or low healthcare cost group [X2 (1) = 10.67, p < .001]. Receiver operator characteristic analysis yielded an area under the curve of .76. A PDQ cutoff score of 96 produced the optimal sensitivity (.70) and specificity (.67) for determining whether patients fall in the high or low healthcare cost group. The linear regression established that PDQ scores at baseline statistically significantly predicted total healthcare utilization at three months following the end of their treatment program, where higher PDQ scores were related to higher healthcare cost [F (1, 48) = 11.41, p = .001]. DISCUSSION: These findings offer support for the use of the PDQ in predicting healthcare cost. Use of the PDQ in this context may help clinicians, caregivers, and patients in planning the cost of the chronic pain sufferers’ treatment. Knowing what to expect financially could help increase the patient’s quality of life.