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Gender Differences in Health Care Utilization Among Veterans with Chronic Pain

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Background

Previous research reports that 48% of veterans regularly experience and express concern over pain. Outpatient service use is higher for veterans with pain than for veterans without pain. Our study objective was to identify differences in outpatient utilization between men and women veterans with chronic pain.

Methods

We identified all men and women veterans at the Durham Veterans Affairs Medical Center in fiscal year (FY) 2002 between the ages of 21 and 60 that had two visits for the same pain location at least 6 weeks apart as determined by ICD-9 coding. Men and women were age-matched at a 2:1 ratio. We then compared the number of outpatient visits between genders in FY 2003.

Results

We identified 406 female and 812 male veterans. The mean number of clinic visits for women was 25.2 (SD 30.2) and for men 17.6 (SD 24.1). After adjusting for multiple pain sites, psychiatric diagnoses, age, and comorbidities, women veterans had a 27% higher rate of outpatient visits than men (incidence rate ratio [RR] 1.27, 95% confidence [CI] 1.15 to 1.41). Specifically, women had higher rates of visits to primary care (RR 1.36, 95% CI 1.24 to 1.50), physical therapy (RR 1.67, 95% CI 1.20 to 2.33), and other clinics (RR 1.28, 95% CI 1.14 to 1.44), and had a higher rate of visits to address pain (RR 1.15, 95% CI 1.02 to 1.30) than men.

Conclusions

This is the first study to examine gender differences in chronic pain and utilization in the veteran population. Women veterans with chronic pain may need more resources to adequately manage chronic pain conditions as well as associated comorbidities and psychiatric disease.

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Disclaimer:

The views expressed herein do not necessarily represent the views of the U.S. Department of Veterans Affairs or the U.S. Government.

Acknowledgements:

Dr. Kaur is supported by VA Fellowship. Dr. Kaur and Dr. Bastian are supported by the Women Veterans Comprehensive Health Center at the Durham Veterans Affairs Medical Center.

Potential Financial Conflicts of Interest:

None disclosed.

Author information

Authors and Affiliations

  1. Health Services Research and Development, Durham Veterans Affairs Medical Center, Durham, NC, USA

    Suneet Kaur MD, MHSc, Karen M. Stechuchak MS, Cynthia J. Coffman PhD, Kelli D. Allen PhD & Lori A. Bastian MD, MPH

  2. Department of Medicine, Duke University Medical Center, Durham, NC, USA

    Suneet Kaur MD, MHSc, Kelli D. Allen PhD & Lori A. Bastian MD, MPH

  3. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA

    Cynthia J. Coffman PhD

  4. Duke Cancer Prevention, Detection, and Control Research, Duke University Medical Center, Durham, NC, USA

    Lori A. Bastian MD, MPH

  5. Durham Regional Hospital, 3643 North Roxboro Road, Durham, NC, 27704, USA

    Suneet Kaur MD, MHSc

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  1. Suneet Kaur MD, MHSc
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  2. Karen M. Stechuchak MS
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  3. Cynthia J. Coffman PhD
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  5. Lori A. Bastian MD, MPH
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Correspondence to Suneet Kaur MD, MHSc.

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Kaur, S., Stechuchak, K.M., Coffman, C.J. et al. Gender Differences in Health Care Utilization Among Veterans with Chronic Pain. J GEN INTERN MED 22, 228–233 (2007). https://doi.org/10.1007/s11606-006-0048-5

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  • DOI: https://doi.org/10.1007/s11606-006-0048-5

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