Economic effects of chronic pain in childhood and adolescence. Self-assessment of health care costs for affected families before and after a multidisciplinary inpatient pain therapy

Background. Chronic pain in children and adolescents causes a high utilization of the health care system and thereby significant costs. The aim of the present study is to describe the economic effects of pediatric chronic pain from the family's perspective. Material and methods. Six months before and 6 and 12 months after a 3-week inpatient-based intensive interdisciplinary pain treatment, the parents of 101 children with chronic pain filled in a standardized cost questionnaire containing the following parameters: (1) child's utilization of medical and social services, (2) subjective financial burden, and (3) type and extent of direct costs. Results. During the 6 months before inpatient-based intensive interdisciplinary pain treatment, children used a median of four different services. After inpatient pain treatment, service utilization has been reduced significantly (p<0.001). One fifth of the families report a high or very high financial burden before treatment. Family's direct costs are most often caused by travelling (86%) and drugs (60%). After inpatient pain treatment, family's financial burden decreased significantly (p<0.001). The frequency of additional expenditures is also reduced after treatment: parents report less additional costs due to travelling and drugs (p<0.001, respectively). Conclusion. The present study emphasizes the pronounced utilization of health and social care due to pediatric chronic pain. In the future, the use of appropriate diagnostic and therapeutic standards that contribute to avoiding unnecessary and expensive interventions is preferred.