General Pain and Frequency of Medical Visits in Family Medicine

Pain assessment and control have received increasing attention as a quality issue in medicine. However, pain has rarely been addressed as a cost-containment issue. We performed a single-center retrospective analysis of information abstracted from the medical records of 1445 adult patients who were treated in family medicine clinics and referred to specialists in Rochester, Minnesota, USA. Patients were categorized into frequent utilizers of physician visits and others, with those having more than eight medical visits in the previous 6 months being classified as frequent users. General pain was self-assessed using a 10-point scale. Multiple logistic regression analysis was used to test the relationship between pain and the frequency of visits, after adjustment for co-morbidities, body mass index (BMI), and demographic characteristics. Findings revealed that patients with pain scores ≥7 had higher odds of being frequent visitors after adjusting for co-morbidity, BMI, age, marital status, and gender (adjusted odds ratio [AOR] = 1.60; 95% CI 1.12, 2.28; p < 0.01). AORs for being a frequent user were significantly greater for patients with ‘moderate’ Charlson co-morbidity scores (AOR = 2.83; 95% CI 2.03, 3.95; p < 0.01) than for those with no co-morbid diseases. They were also lower for men than for women (AOR = 0.71; 95% CI 0.54, 0.94; p = 0.02), but higher for unmarried persons than for married persons (AOR = 1.72; 95% CI 1.28, 2.32; p < 0.01). Severe pain is associated with being a more frequent user of medical services.