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Background <p>Chronic pain (CP) affects up to 1 in 4 individuals and disproportionately impacts women, gender minorities, and other equity-deserving groups, highlighting the need for an equity-oriented approach to provide optimal care. The relationship between sex, gender, and frequent healthcare utilization remains underexplored among individuals living with CP. Therefore, this study aimed to examine the associations between sex, gender and frequent medical care utilization among persons living with CP.</p> Methods <p>The COPE Cohort, composed of persons living with CP, was formed by linking a web-based questionnaire with health administrative databases. Frequent medical care users were defined as the top 10% of our sample with the highest number of all-cause medical visits in the year following the completion of the questionnaire (including outpatient and emergency department visits). Sex (male / female), gender identity (men / women / gender-diverse), and gender-stereotyped personality traits (masculine / feminine / androgynous / undifferentiated; Bem Sex-Role Inventory) were analyzed. Cluster analysis was used to create intersecting sociodemographic subgroups (incorporating sex, gender, region of residence, country of birth, education level, employment status, and age).</p> Results <p>Among 895 participants, 95 were classified as frequent medical care users (10% cut-off: ≥13 visits/year). The proportion of frequent users varied across sex (male: 3.9% vs. female: 12.0%, <i>p</i> = 0.003) and gender identity (men: 4.0% vs. women: 12.1% vs. gender-diverse: 0%, <i>p</i> = 0.009), but not by gender-stereotyped personality traits subgroups. Multivariable logistic regression showed that the subgroup labelled ‘unemployed more educated women’ (compared to ‘men’) had increased odds of being frequent medical care users (OR: 3.93, 95%CI: 1.44–10.80).</p> Conclusion <p>Based on our results, we emphasize the need for clinicians and decision-makers to adopt an integrated approach that considers not only clinical, but importantly, socioeconomic profiles for effective healthcare.</p>

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A sex- and gender-based analysis plus of frequent healthcare utilization among individuals living with chronic pain: a cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月1日

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  • Marimée Godbout-Parent,
  • Nancy Julien,
  • Hermine Lore Nguena Nguefack,
  • M. Gabrielle Pagé,
  • Line Guénette,
  • Lucie Blais,
  • Anaïs Lacasse

摘要

Background

Chronic pain (CP) affects up to 1 in 4 individuals and disproportionately impacts women, gender minorities, and other equity-deserving groups, highlighting the need for an equity-oriented approach to provide optimal care. The relationship between sex, gender, and frequent healthcare utilization remains underexplored among individuals living with CP. Therefore, this study aimed to examine the associations between sex, gender and frequent medical care utilization among persons living with CP.

Methods

The COPE Cohort, composed of persons living with CP, was formed by linking a web-based questionnaire with health administrative databases. Frequent medical care users were defined as the top 10% of our sample with the highest number of all-cause medical visits in the year following the completion of the questionnaire (including outpatient and emergency department visits). Sex (male / female), gender identity (men / women / gender-diverse), and gender-stereotyped personality traits (masculine / feminine / androgynous / undifferentiated; Bem Sex-Role Inventory) were analyzed. Cluster analysis was used to create intersecting sociodemographic subgroups (incorporating sex, gender, region of residence, country of birth, education level, employment status, and age).

Results

Among 895 participants, 95 were classified as frequent medical care users (10% cut-off: ≥13 visits/year). The proportion of frequent users varied across sex (male: 3.9% vs. female: 12.0%, p = 0.003) and gender identity (men: 4.0% vs. women: 12.1% vs. gender-diverse: 0%, p = 0.009), but not by gender-stereotyped personality traits subgroups. Multivariable logistic regression showed that the subgroup labelled ‘unemployed more educated women’ (compared to ‘men’) had increased odds of being frequent medical care users (OR: 3.93, 95%CI: 1.44–10.80).

Conclusion

Based on our results, we emphasize the need for clinicians and decision-makers to adopt an integrated approach that considers not only clinical, but importantly, socioeconomic profiles for effective healthcare.