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Critical Reviews™ in Physical and Rehabilitation Medicine
Treatment of Chronic Pain Patients: Clinical Outcomes, Cost-Effectiveness, and Cost-Benefits of Multidisciplinary Pain Centers
Dennis C. Turk
Department of Anesthesiology, University of Washington, Seattle, WA 98195
Associate Professor, Department of Anesthesiology, Pain Research and Management Center, University of Utah, UT 84108 University of Washington, Seattle, WA 98195
Chronic pain is difficult to treat successfully. The lack of satisfactory outcomes from the traditional medical, pharmacological, and surgical approaches was an impetus to the development of specialty treatment facilities − Multidisciplinary Pain Centers (MPCs). With health care costs continuing to rise, the clinical efficacy, cost-benefits, and cost-effecctiveness of MPCs have been challenged. In this paper, we will argue that the multifactorial nature of chronic pain makes it imperative that the efficacy of treatment should be evaluated on multiple criteria: reduction in pain, emotional distress, use of analgesic medication, and utilization of health care services. Increases in functional activity, return to work, levels of iatrogenic problems, and closure of disability claims should also be considered. The review of the published outcome results for MPCs, in comparison with alternative medical and surgical treatment methods, supports the greater efficacy of the MPC approach. Furthermore, it is concluded that MPCs can save billions of dollars in health care expenditures, indemnity costs, lost tax revenue, replacement workers, and legal costs.
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