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Health utilities in people with chronic pain using a population-level survey and linked healthcare administrative data

Hogan ME, Taddio A, Katz J, Shah V, Krahn M. Pain. 2017; 158(3):408-16. Epub 2016 Nov 24.


Health utilities are a preference-based measure of health-related quality of life that facilitates comparison of disease burden across conditions. We estimated utilities using a population-based, matched sample of adolescents and adults with and without chronic pain, controlling for comorbidity.Ontarians aged ≥12 years with and without chronic pain were identified from the Canadian Community Health Survey (CCHS) 2000-01 and 2009-10 and linked to their provincial healthcare administrative data. Individuals with chronic pain were matched to those without using age, sex, survey year, and a propensity score for having chronic pain estimated from a rurality index, income quintile and comorbidity. The Health Utilities Index Mark 3 instrument, included in the CCHS, was used. Mean utilities were calculated for each group. Utility decrement for chronic pain was also calculated for each matched pair.A total of 65,246 responses were available for analysis. After matching, there were 12,146 matched pairs with and without pain. In the matched cohort, mean age was 54 years (SD 12); 61% were female. The matched cohort with chronic pain had a mean utility of 0.59 (95% CI 0.58 to 0.59), and the decrement associated with chronic pain was 0.32 (95% CI 0.31 to 0.32).Utilities in people with chronic pain were lower than, and decrements larger than, those seen with most other chronic diseases including heart disease, diabetes and chronic obstructive pulmonary disease. This data will be useful to inform priorities and future strategies for the prevention and control of chronic pain.

Keywords: Chronic diseases and conditions Research and statistical methods Health care utilization

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