Regional comparison of specialized outpatient and (partial) inpatient pain medicine care in Germany

Background and objective Chronic pain requires graduated and staged levels of care. The aim of this study is to provide a regional overview regarding the accessibility of specialized outpatient and (partial) inpatient pain medicine care from the patient's perspective in Germany. Material and methods For 1000 model patients randomly generated from German postal code location combinations, the travelling time by car (individual transport, IT) and available public transport connections (PTC) to the nearest specialized outpatient and inpatient pain medicine clinics and units were assessed using a route planner. Results Outpatient facilities (in a practice setting) were mostly realistically accessible depending on the proportion of pain treatment and the networking structure. University pain outpatient clinics were at a critically reachable distance with IT for 70% of the patients (80% with PTC) and had unrealistic accessibility for 49% of the patients with IT (68% with PTC). Interdisciplinary multimodal pain programs in day clinics were at a critically reachable distance for 68% of patients with IT (83% with PTC) and in 49% (75% PTC) at an unrealistic travelling time distance considering the more intense treatment requiring frequent travel. Full inpatient interdisciplinary multimodal treatment was more realistically reachable (IT 39% critical, 14% unrealistic, PTC 61% critical, 48% unrealistic). Conclusion The results show relevant nationwide differences in the accessibility of facilities for specialized pain treatment depending on the place of residence. Considering the treatment of a chronic condition with long-term therapeutic goals and the need for graduated care (outpatient and inpatient treatment), the results reveal a partly critical situation from the patient's perspective.