Complex acute pain management in German hospitals: retrospective analysis of regional differences

Abstract

Complex acute pain therapy is a therapeutic measure for special pain therapy and symptom control in patients with severe acute pain conditions. This severe acute pain can occur, for example, after operations, accidents or also with severe, exacerbated tumours. Complex acute pain therapy is coded using the operation and procedure code (OPS) 8-919 (DIMDI, 2023). In 2021, there were a total of more than 16.6 million hospital cases in Germany, and complex acute pain treatment was prescribed for more than 200,000 of these cases (InEK, 2023). Based on hospital diagnoses, it is known that there are regional differences in Germany for osteoporotic fractures as well as hospital deaths after femoral fracture and heart failure, among others (Möckel, 2022; Möckel et al., 2020, 2023; Wachter et al., 2015). A study by Hoffmann et al. (2020) was additionally able to show that there are regional differences in Germany in the prescription of the painkiller metamizole. In this analysis, the prevalence of use was lowest in Saxony with 7.0% and highest in Schleswig-Holstein with 11.1% (Hoffmann et al., 2020). It should also be noted here that between 1998 and 2008-2011, the use of painkillers in Germany increased from 19% to 21%. This increase is primarily due to over-the-counter painkillers (10.0% to 12.2%), whereas the use of prescription painkillers remained constant (Sarganas et al., 2015). In the study by Sarganas et al. (2015), females, increasing age, obese individuals and smokers showed the higher odds of using prescription painkillers. In contrast, higher socioeconomic status and more weekly physical activity were associated with lower odds (Sarganas et al., 2015).