The relationship between chronic illness, chronic pain, and socioeconomic factors in the ED

Am J Emerg Med. 2011 Mar;29(3):286-92. doi: 10.1016/j.ajem.2009.10.002. Epub 2010 Apr 2.

Abstract

Objectives: The study aimed to determine the prevalence of chronic illness and chronic pain in emergency department (ED) patients across demographic backgrounds.

Methods: This was a cross-sectional study at an urban, level I trauma center with 98,000 annual visits. This was a prospective sample of adult patients presenting to the ED during a randomized distribution of daily 8-hour periods between June 4 and August 26, 2007. Prevalence of chronic illness was compared to subject demographics using logistic regression, and prevalence of chronic pain was compared using ordinal logistic regression.

Results: Six thousand nine hundred sixty-one patients presented during the data collection periods; 3882 were eligible, and 3132 (82%) were enrolled (51.7% male; age, 41.1 ± 15.8 years; range, 18-98 years). Chronic illness was reported in 36.3% of patients and chronic pain in 34.9% of patients. Chronic illness was associated with homelessness (odds ratio [OR], 1.75; 95% confidence interval [CI], 1.17-2.61), family income less than $25,000 (OR, 2.27; 95% CI, 1.60-3.22), and lack of access to primary care facilities (OR, 2.68; 95% CI, 2.25-3.21). Chronic pain was associated with homelessness (OR, 2.56; 95% CI, 1.79-3.64), family income less than $25,000 (OR, 2.54; 95% CI, 1.91-3.39), and lack of access to primary care facilities (OR, 1.47; 95% CI, 1.26-1.70).

Conclusions: Patient housing situation, family income, and perceived access to primary care medical facilities were associated with higher self-reported rates of chronic illness and chronic pain.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease / epidemiology*
  • Confidence Intervals
  • Cross-Sectional Studies
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Ill-Housed Persons / statistics & numerical data
  • Income
  • Logistic Models
  • Male
  • Middle Aged
  • Minnesota
  • Odds Ratio
  • Pain / epidemiology*
  • Prospective Studies
  • Socioeconomic Factors
  • Trauma Centers / statistics & numerical data
  • Young Adult