Association and attributable hospital costs of chronic pain with relevant geriatric sensitive diseases among the older adults

BackgroundThe adverse impacts of chronic pain extend far beyond the physical sensation itself. Chronic pain, an age-related condition, exacerbates geriatric disease burden and drives a central sensitivity-neuropsychiatric complex, necessitating urgent preventive care. This study aimed to investigate the impact of chronic pain on two sensitive diseases, depression, and abilities decline in basic or physical activities (functional limitation) among the inpatients in older adults and explore the attributable hospital costs related to chronic pain.MethodParticipants were sourced from the 2021–2022 Inpatient Discharge Dataset of Sichuan Province, Diagnosis of depression, functional limitation, and chronic pain were identified using International Classification of Diseases, 10th Revision (ICD-10) codes. Logistic regression models were employed to analyze the association between chronic pain and depression and functional limitation. Furthermore, total hospital costs, out-of-pocket costs and length of stay (LOS) were compared between patients (depression and functional limitation) with chronic pain and without using Propensity score matching and Multivariable linear regression.ResultsThe analysis included 38,372 and 4,996 inpatients in the depression and functional limitation cohorts, respectively. Chronic pain was significantly associated with both outcomes, yielding odds ratios (ORs) of 1.24 (95% CI: 1.20–1.27) for depression and 1.60 (1.44–1.78) for functional limitation (all p < 0.001), and the effect intensified as the number of painful areas increased. Compared to those without pain, depression patients with chronic pain incurred 68.2% higher total hospital costs (β=0.52, p < 0.001), 169.1% higher out-of-pocket (β=0.99, p < 0.001) and 60.0% higher LOS (β=0.47, p < 0.001). Among patients with Functional limitation, chronic pain also significantly increased log-transformed total costs (β=0.20), out-of-pocket (β=0.51), and LOS (β=0.30), representing relative increases of 22.1, 66.5, and 35.0%, respectively (all p < 0.05). These economic impacts were more pronounced among patients with multi-area pain.DiscussionThis study provides empirical evidence linking chronic pain to deteriorated psychological and physical health among older adults. It highlights the increased burden of the disease and hospitalization, with a particular emphasis on the dangers of multi-area pain. These findings emphasize that prioritizing mental health-focused pain management in outpatient and emergency settings is crucial for preventing avoidable hospitalizations and hospitalization costs in older adults.