Clinical Outcome and Economic Evaluation of Multidisciplinary Pain Centers
Akiko Okifuji Dennis C. Turk Donna Kalauokalani University of Washington
Chronic pain is one of the most prevalent conditions in Western society. It has been estimated that over 90 million Americans suffer from some form of persistent or recurrent pain (Marketdata Enterprises, 1995). Chronic pain is also a costly condition for society due to health care expenditures and indirect costs associated with disability compensations and loss of productivity resulting from absenteeism. Updating Bonica ( 1986) figures and using Frymoyer and Durett ( 1997) data on changes in medical and hospital charges, we can estimate that over $125 billion are expended annually on health care to treat chronic pain sufferers.
Not only does chronic pain adversely affect patients' physical well-being, but it also leads to substantial declines in familial, emotional, social, and occupational functioning. Patients and their families feel progressively more distressed as medical costs escalate and disability increases. Health care providers frequently become frustrated as treatment options are exhausted while reports of pain and disability persist.
In general, pain experience results from acute tissue damage that resolves spontaneously or with treatment, rarely causing significant disability. In these instances, pain serves as a warning sign of underlying pathology. In the case of acute pain, there appears to be a close relationship between