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Published on: January 27, 2010
Influence of parental occupation on access to specialised treatment for paediatric chronic pain: a retrospective
J Wager1, A Ruhe, G Hirschfeld
1Department of Children's Pain Therapy and Paediatric Palliative Care, School of Medicine, Children's and Adolescents' Hospital, Datteln, Witten/Herdecke University, Dr.-Friedrich-Steiner Str. 5, 45711, Datteln, Germany. J.Wager@Kinderklinik-Datteln.de
Insights
Children from higher socioeconomic backgrounds travel further to pediatric pain clinics, indicating potential access barriers. Addressing these disparities requires more specialized healthcare facilities for pediatric chronic pain.
Area of Science:
- Pediatric Pain Management
- Health Services Research
- Socioeconomic Determinants of Health
Background:
- Tertiary pediatric pain clinics serve a crucial role in managing complex pain conditions in children.
- Understanding patient travel distances is essential for evaluating healthcare accessibility and equity.
Purpose of the Study:
- To determine patient travel distances to a tertiary pediatric pain clinic.
- To analyze the association between travel distance and parental occupational skill level.
- To examine the relationship between travel distance and pediatric pain characteristics.
Main Methods:
- Retrospective study of 2,248 children (0-20 years) assessed at a tertiary pediatric pain clinic.
- Data collected during a 5-year period (2005-2010) included patient demographics, pain characteristics, and parental occupational skill level.
- Analysis focused on travel distance, catchment area, and correlations with patient and family factors.
Main Results:
- The mean travel distance was 81 km, with an 80% catchment area of 109 km.
- Children of parents with high occupational skill levels were 1.5 times more likely to travel from outside the standard catchment area.
- Increased travel distance correlated with higher patient impairment, musculoskeletal pain, longer pain duration, and more frequent physician contacts.
Conclusions:
- The correlation between travel distance and parental occupational skill level highlights socioeconomic disparities in healthcare access.
- These findings suggest potential social injustice stemming from barriers related to socioeconomic status and education.
- Expanding access to pediatric chronic pain services is recommended to mitigate these inequities.
Background:
The purpose of this study was to determine patients' travel distances to a tertiary paediatric pain clinic and to analyse the association between travel distance and the parents' occupational skill level and the patients' pain characteristics.
Patients And Methods:
The retrospective study consisted of 2,248 children assessed at the first evaluation. All children (0-20 years) who visited the clinic during a 5-year period (2005-2010) were enrolled in this study.
Results:
The mean travel distance was 81 km, and the 80 % catchment area was 109 km. Children of parents with a high occupational skill level had a 1.5-fold higher probability of travelling from outside the catchment area. The 80 % catchment area increased constantly with increasing occupational skill level. Additional significant factors for greater distance travelled were high impairment, musculoskeletal pain, long pain duration and a high number of previous physician contacts.
Conclusion:
The association between travel distance and parental occupational skill level suggests that there is social injustice due to access barriers based on socioeconomic deprivation and education. An increase in the number of health care facilities for chronic pain in children would be a first step in rectifying this injustice.
