AGE AS A FACTOR IN ADMISSION TO CHRONIC PAIN REHABILITATION

Objective: To examine access to multidisciplinary pain rehabilitation programs for older patients. Design: Telephone and written surveys of pain programs accredited by Commission on Accreditation of Rehabilitat ion Facilities. Visual Analog Scale (VAS) ratings of patient vignettes in which older patients were alternatively assigned their true age or a younger age. Participants: Health care professionals at pain progra ms. Main Outcome Measures: Telephone survey of admission policies and treatment services. VAS ratings of patient vignettes. Results: No prog ram excludes older pain patients by age. However, 28% of programs had admitted only the youngest old (< 70 years). Age-related criteria, suc h as presence of concurrent medical diagnoses that are more likely to exclude older patients, are common. In addition, VAS ratings of patien t vignettes indicated an age bias: the same patients were rated as 14. 8% less likely to be admitted (p < .001) and 12.5% less likely to succ eed if admitted (p < .001) when their true, older age was given than w hen a false younger age was provided. Conclusion: Pain program admissi on policies do not exclude older patients by age but frequently includ e age-related criteria that disproportionately exclude the elderly. Th ere is also evidence of an age bias in which age per se reduces percei ved suitability for pain program admission.