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Equal access to pain rehabilitation in Swedish tertiary care. Are sociodemographic factors associated with selection to rehabilitation?
University of Gothenburg.
University of Gothenburg.
University of Gothenburg.
Blekinge Institute of Technology, Faculty of Engineering, Department of Health.ORCID iD: 0000-0002-0442-9862
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2026 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 26, no 1, article id 20260004Article in journal (Refereed) Published
Abstract [en]

Objectives To investigate if sociodemographic factors are associated with selection to an interdisciplinary pain rehabilitation program (IPRP) in Swedish tertiary care, in an intersectional perspective.

Methods This study involved 39,346 patients referred to tertiary care, who were registered in the Swedish Quality Registry for Pain Rehabilitation during 2009-2016. Self-reported sociodemographic data, and data related to pain and its consequences, were registered prior to IPRP (at baseline). Self-reported data on pain and its consequences were also registered directly after the IPRP and at a 12 months' follow-up. Patients not selected for IPRP reported only baseline data. The statistical analyses used logistic regressions including interaction terms, and the results were analyzed in an intersectional framework to emphasize unequal health care.

Results Sex, age, education, and region of birth were found to influence the likelihood of being selected to IPRP. Non-Nordic-born patients with elementary education had the lowest proportion of selection to IPRP, with a similar proportion for men and women. Other subgroups showed a smaller difference between Nordic and non-Nordic countries in the proportion selected to IPRP. For several groups, longer education had a positive impact on the proportion of selection. Selection increased with age to a peak in middle age and then decreased. Unexpectedly, the youngest patients were less likely than middle-aged patients to be selected.

Conclusions In Swedish tertiary care, sex, age, education, and region of birth influence selection to IPRP as combinations but not necessarily as single factors. More knowledge is needed to ensure equal, knowledge-based rehabilitation for patients with chronic pain. The regional ethics review board in Uppsala (IRB/REC 2018/036) and the Swedish ethical review authority (IRB/REC 2020-00828) issued ethical approvals.

Place, publisher, year, edition, pages
Walter de Gruyter, 2026. Vol. 26, no 1, article id 20260004
Keywords [en]
chronic pain, sociodemographic factors, selection bias, rehabilitation, registries
National Category
Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:bth-29485DOI: 10.1515/sjpain-2026-0004ISI: 001754195300001PubMedID: 42068060Scopus ID: 2-s2.0-105037773325OAI: oai:DiVA.org:bth-29485DiVA, id: diva2:2058771
Funder
AFA InsuranceRegion Västra GötalandAvailable from: 2026-05-08 Created: 2026-05-08 Last updated: 2026-05-18Bibliographically approved

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Sandin Wranker, Lena

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