Accessibility of Chronic Pain Treatment for Individuals Injured in a Motor Vehicle Accident

Abstract

Background: Chronic Pain (CP) is a pervasive problem that can drastically lower one’s quality of life. Therefore, it is imperative that CP sufferers receive appropriate intervention. At the Michael G. DeGroote Pain Clinic of Hamilton Health Sciences, assessed individuals are either recommended or not recommended for admission into the four-week interdisciplinary pain management Program. Despite receiving recommendation for admission, many are denied insurance coverage for unspecified reasons and cannot undergo required treatment.
Purpose: To investigate if there were clinically significant differences in demographics and pain-related measures between individuals granted versus denied insurance coverage for CP treatment.
Methods: Data were collected from 99 patients recommended for admission into the Program. Pain-related questionnaire scores and demographic information were compared between patients denied coverage (n=49) and patients granted coverage (n=50) using two-way MANOVA and Pearson chi-square tests of independence.
Results: Findings on pain-related variables revealed scores that warranted clinical attention in all patients. The majority of measures revealed no patient need-related differences between groups. Pain Stages of Change Questionnaire (PSOCQ) contemplation scores between groups were significantly, yet not clinically, different. Consistent with the literature, Tampa Scale for Kinesiophobia and PSOCQ pre-contemplation scores were significantly higher in males than females.
Conclusions: As hypothesized, these findings strongly support the hypothesis that there are no clinically meaningful differences between groups, suggesting that the separation of groups established by insurance companies was artificial, and not based on any tangible clinical factors. It also implies that insurance companies are likely provisioning funds on systems-related rather than patient need-related criteria.