The societal burden of pain in Germany: Health-related quality-of-life, health status and direct medical costs

Figures & data

Table 1.  Reported pain severity and frequency of pain, Germany, 2010.

	Unweighted estimates		Weighted estimates
Pain dimension	Respondents	Distribution (%)	Respondents	Distribution (%)
Pain level
Mild	974	27.56	4,287,259	26.16
Moderate	2095	59.28	10,048,240	61.32
Severe	465	13.16	2,050,277	12.51
Pain frequency
Daily	1424	40.29	7,235,234	44.16
4–6 times a week	436	12.34	2,016,621	12.31
2–3 times a week	717	20.29	3,182,122	19.42
Weekly or less	957	27.08	3,951,799	24.12
Pain level and frequency
Severe daily pain	348	9.85	1,606,507	9.80
Severe and 4–6 times per week	39	1.1	154,565	0.94
Severe and 2–3 times per week	36	1.02	133,397	0.81
Severe and weekly or less	42	1.19	155,808	0.95
Moderate daily pain	910	25.75	4,832,068	29.49
Moderate and 4–6 times a week	306	8.66	1,422,136	8.68
Moderate and 2–3 times per week	448	12.68	2,019,941	12.33
Moderate and weekly or less	431	12.2	1,774,095	10.83
Mild daily pain	166	4.7	796,659	4.86
Mild and 2–6 times per week	324	9.17	1,468,704	8.96
Mild and weekly or less	484	13.7	2,021,896	12.34
Total	3534	100.00	16,385,776	100.00

Note: Estimates are weighted by age and gender

Source: NHWS, 2010.

Table 2.  Respondent characteristics, Germany, 2010.

Independent variables	No pain distribution (%)	Pain distribution (%)	Pain prevalence (%)
Socio-demographic variables
Age: 18–39 years	33.88	25.21	18.99
Age: 40–59 years	36.93	42.88	26.78
Age: 60 years and older	29.19	31.90	25.62
Gender: female	48.04	61.50	28.74
Gender: male	51.96	38.50	18.92
Education: University or higher	4.94	29.69	29.69
Education: High school completed	51.10	26.44	26.44
Education: Other	43.97	20.08	20.08
Income: Under €20,000	21.47	27.18	28.50
Income: €20,000–€39,999	40.81	42.69	24.78
Income: €40,000 and above	19.41	15.90	20.51
Income reporting declined	18.30	14.24	19.68
Health risk behaviors
BMI: Underweight	2.10	1.57	19.07
BMI: Normal weight	35.88	27.60	19.51
BMI: Overweight	38.51	36.57	23.02
BMI: Obese	18.82	27.36	31.41
BMI: Morbidly obese	2.32	4.78	39.42
BMI: reporting declined	2.37	2.11	21.88
Current smoker	25.53	29.45	26.66
Alcohol user	5.64	6.53	26.72
Morbidity/comorbidity status
Charlson Comorbidity Index (SD)	0.274 (0.712)	0.571 (1.039)	n/a

SD, standard deviation; all estimates weighted by age and gender; n/a, not applicable.

Source: NHWS, 2010.

Table 3.  Health-related quality-of-life, persons reporting pain by pain severity and no pain, Germany, 2010.

HRQoL	Persons reporting no pain (SD)	Persons reporting pain (SD)	Persons reporting mild pain (SD)	Persons reporting moderate pain (SD)	Persons reporting severe pain (SD)
SF-12 PCS	49.90 (8.19)	40.52 (10.23)	47.47 (7.45)	39.48 (9.28)	31.07 (10.08)
SF-12 MCS	47.91 (10.16)	43.35 (10.90)	46.26 (9.85)	43.13 (10.88)	38.31 (11.10)
SF-6D utilities	0.75 (0.13)	0.64 (0.12)	0.71 (0.11)	0.63 (0.10)	0.54 (0.10)

Note: estimates weighted by age and gender; SD, standard deviation.

Source: NHWS, 2010.

Table 4.  Self-reported health status, persons reporting pain by pain severity and no pain, Germany, 2010.

Self-reported health status	Persons reporting no pain (%)	Persons reporting pain (%)	Persons reporting mild pain (%)	Persons reporting moderate pain (%)	Persons reporting severe pain (%)
Excellent	7.18	0.68	1.17	0.49	0.57
Very good	31.96	11.21	23.91	7.35	3.57
Good	47.26	44.56	56.96	44.02	21.22
Fair	12.09	36.34	16.51	43.52	42.63
Poor	1.50	7.21	1.45	4.61	32.01

Note: Estimates weighted by age and gender.

Source: NHWS, 2010.

Table 5.  Healthcare resource utilization and direct medical costs, persons reporting pain by pain severity and no pain, Germany, 2010.

Healthcare resource utilization	Persons reporting no pain	Persons reporting pain	Persons reporting mild pain	Persons reporting moderate pain	Persons reporting severe pain
Traditional provider visits (SD)	5.11 (6.69)	10.37 (10.74)	6.52 (7.03)	10.88 (10.99)	15.97 (12.73)
Emergency room visits (SD)	0.09 (0.48)	0.20 (0.72)	0.12 (0.49)	0.19 (0.63)	0.43 (1.30)
Hospitalizations (SD)	0.09 (0.57)	0.21 (0.73)	0.10 (0.42)	0.20 (0.58)	0.48 (1.47)
Direct medical mean costs (SD) (€)
Traditional provider visits	149.84 (196.31)	304.36 (315.02)	191.14 (206.37)	319.16 (322.47)	468.56 (373.55)
Emergency room visits	14.65 (75.71)	31.82 (113.71)	18.18 (76.45)	30.19 (98.54)	68.37 (204.43)
Hospitalizations	94.46 (579.30)	215.36 (747.14)	101.70 (432.76)	207.24 (591.56)	492.82 (1500.10)
Total costs	258.96 (687.43)	551.55 (948.24)	311.03 (560.96)	556.59 (789.49)	1029.75 (1767.38)
Direct medical median costs (25–75th quartile range) (€)
Traditional provider visits	88.02 (29.34–176.04)	205.38 (117.36–410.76)	117.36 (58.68–234.72)	234.72 (117.36–410.76)	381.42 (205.38–616.14)
Median direct cost	88.02 (29.34–205.38)	234.72 (117.36–557.46)	146.70 (58.68–293.40)	264.06 (117.36–568.36)	498.78 (234.72–1355.83)

Note: Estimates weighted by age and gender; SD, standard deviation; costs are estimated for those reporting costs only for that category; all costs are in Euros.

Source: NHWS, 2010.

Table 6.  Regression results: SF-12 Physical component score, Germany, 2010.

	Model 1: Pain severity		Model 2: Pain severity and frequency
	Coefficient	95% CI	Coefficient	95% CI
Independent variables
Pain level reported in last month^A
Mild	−2.258	−2.743 to −1.774
Moderate	−7.879	−8.232 to −7.527
Severe	−15.510	−16.200 to −14.810
Pain level and frequency^A
Severe daily pain			−17.930	−18.720 to −17.140
Severe pain 4–6 times a week			−12.450	−14.740 to −10.160
Severe pain 2–3 times a week			−7.796	−10.180 to −5.410
Severe pain weekly or less			−6.178	−8.386 to −3.971
Moderate daily pain			−10.690	−11.200 to −10.190
Moderate pain 4–6 times a week			−8.257	−9.088 to −7.425
Moderate pain 2–3 times a week			−6.570	−7.260 to −5.879
Moderate pain weekly or less			−3.432	−4.134 to −2.729
Mild daily pain			−4.004	−5.122 to −2.886
Mild pain 2–6 times a week			−3.347	−4.152 to −2.543
Mild pain weekly or less			−0.931	−1.594 to −0.267
Socio-demographic variables
Age: 40–59 years^1	−2.892	−3.172 to −2.612	−2.625	−2.902 to −2.348
Age: 60 years and older^1	−5.143	−5.489 to −4.796	−4.738	−5.082 to −4.395
Gender: male^2	0.898	0.648 to 1.148	0.835	0.589 to 1.082
Education: High school completed^3	0.451	−0.101 to 1.002	0.467	−0.076 to 1.010
Education: University or higher^3	1.781	1.216 to 2.346	1.758	1.202 to 2.315
Income: €20,000–€39,999^4	0.853	0.538 to 1.169	0.752	0.441 to 1.063
Income: €40,000 and above^4	1.604	1.224 to 1.985	1.444	1.069 to 1.818
Income reporting declined^4	1.261	0.875 to 1.646	1.137	0.756 to 1.517
Health risk behaviors
BMI: Underweight^5	−1.084	−1.895 to −0.274	−1.096	−1.895 to −0.298
BMI: Overweight^5	−0.612	−0.901 to −0.324	−0.540	−0.824 to −0.255
BMI: Obese^5	−2.892	−3.233 to −2.552	−2.814	−3.149 to −2.478
BMI: Morbidly obese^5	−6.022	−6.735 to −5.308	−5.899	−6.602 to −5.196
BMI: Declined to answer^5	−3.588	−4.367 to −2.810	−3.468	−4.235 to −2.702
Current smoker^6	−0.049	−0.321 to 0.224	−0.075	−0.343 to 0.193
Alcohol user^7	−0.619	−1.149 to −0.089	−0.575	−1.097 to −0.053
Morbidity/comorbidity status
Charlson Comorbidity Index	−2.345	−2.499 to −2.191	−2.266	−2.418 to −2.114
Constant	51.810	51.210 to 52.420	51.690	51.100 to 52.290
n	15,070		15,070
Adj R^2	0.374		0.393

Reference categories: ^A no pain reported in last month; ¹ age 18–39 years; ² females; ³ not completed high school; ⁴ income under €20,000; ⁵ BMI normal weight; ⁶ non-smoker; ⁷ non-drinker.

Table 7.  Regression results: SF-12 Mental component score, Germany, 2010.

	Model 1: Pain severity		Model 2: Pain severity and frequency
	Coefficient	95% CI	Coefficient	95% CI
Independent variables
Pain level reported in last month^A
Mild	−1.232	−1.880 to −0.585
Moderate	−4.143	−4.614 to −3.671
Severe	−8.231	−9.163 to −7.299
Pain level and frequency^A
Severe daily pain			−8.787	−9.857 to −7.716
Severe pain 4–6 times a week			−9.068	−12.180 to −5.960
Severe pain 2–3 times a week			−6.885	−10.120 to −3.648
Severe pain weekly or less			−4.399	−7.393 to −1.404
Moderate daily pain			−4.551	−5.233 to −3.868
Moderate pain 4–6 times a week			−5.088	−6.216 to −3.960
Moderate pain 2–3 times a week			−4.554	−5.490 to −3.617
Moderate pain weekly or less			−2.302	−3.255 to −1.349
Mild daily pain			0.163	−1.353 to 1.679
Mild pain 2–6 times a week			−2.740	−3.832 to −1.649
Mild pain weekly or less			−0.703	−1.603 to 0.197
Socio-demographic variables
Age: 40–59 years^1	2.262	1.888 to 2.637	2.333	1.957 to 2.708
Age: 60 years and older^1	5.825	5.362 to 6.288	5.908	5.442 to 6.374
Gender: male^2	1.431	1.097 to 1.765	1.413	1.079 to 1.747
Education: High school completed^3	2.348	1.611 to 3.086	2.337	1.600 to 3.074
Education: University or higher^3	2.703	1.948 to 3.459	2.676	1.921 to 3.431
Income: €20,000–€39,999^4	1.596	1.175 to 2.018	1.582	1.160 to 2.004
Income: €40,000 and above^4	2.809	2.301 to 3.317	2.753	2.245 to 3.261
Income reporting declined^4	2.887	2.371 to 3.403	2.848	2.332 to 3.364
Health risk behaviors
BMI: Underweight^5	−3.185	−4.269 to −2.101	−3.148	−4.231 to −2.065
BMI: Overweight^5	0.163	−0.223 to 0.549	0.188	−0.197 to 0.574
BMI: Obese^5	−0.529	−0.984 to −0.074	−0.499	−0.954 to −0.045
BMI: Morbidly obese^5	−0.751	−1.705 to 0.203	−0.722	−1.675 to 0.232
BMI: Declined to answer^5	−0.295	−1.336 to 0.746	−0.240	−1.280 to 0.801
Current smoker^6	−0.358	−0.721 to 0.006	−0.366	−0.730 to −0.003
Alcohol user^7	−1.024	−1.732 to −0.315	−1.011	−1.719 to −0.303
Morbidity/comorbidity status
Charlson Comorbidity Index	−1.416	−1.622 to −1.210	−1.394	−1.600 to −1.188
Constant	41.240	40.430 to 42.040	41.220	40.410 to 42.030
n	15,070		15,070
Adj R^2	0.121		0.123

Reference categories: ^A no pain reported in last month; ¹ age 18–39 years; ² females; ³ not completed high school; ⁴ income under €20,000; ⁵ BMI normal weight; ⁶ non-smoker; ⁷ non-drinker.

Table 8.  Regression results: SF-6D utilities, Germany, 2010.

	Model 1: Pain severity		Model 2: Pain severity and frequency
	Coefficient	95% CI	Coefficient	95% CI
Independent variables
Pain level reported in last month^A
Mild	−0.035	−0.042 to −0.027
Moderate	−0.100	−0.105 to −0.094
Severe	−0.180	−0.192 to −0.169
Pain level and frequency^A
Severe daily pain			−0.201	−0.214 to −0.188
Severe pain 4–6 times a week			−0.158	−0.196 to −0.120
Severe pain 2–3 times a week			−0.118	−0.157 to −0.078
Severe pain weekly or less			−0.097	−0.133 to −0.060
Moderate daily pain			−0.122	−0.130 to −0.114
Moderate pain 4–6 times a week			−0.107	−0.121 to −0.094
Moderate pain 2–3 times a week			−0.095	−0.106 to −0.083
Moderate pain weekly or less			−0.056	−0.067 to −0.044
Mild daily pain			−0.030	−0.048 to −0.012
Mild pain 2–6 times a week			−0.056	−0.070 to −0.043
Mild pain weekly or less			−0.022	−0.033 to −0.011
Socio-demographic variables
Age: 40-59 years^1	0.006	0.001 to 0.010	0.008	0.003 to 0.013
Age: 60 years and older^1	0.021	0.015 to 0.027	0.024	0.019 to 0.030
Gender: male^2	0.023	0.019 to 0.027	0.022	0.018 to 0.026
Education: High school completed^3	0.018	0.009 to 0.027	0.018	0.009 to 0.027
Education: University or higher^3	0.026	0.017 to 0.035	0.026	0.017 to 0.035
Income: €20,000–€39,999^4	0.019	0.014 to 0.024	0.018	0.013 to 0.023
Income: €40,000 and above^4	0.038	0.032 to 0.044	0.036	0.030 to 0.042
Income reporting declined^4	0.037	0.030 to 0.043	0.035	0.029 to 0.042
Health risk behaviors
BMI: Underweight^5	−0.039	−0.052 to −0.026	−0.039	−0.052 to −0.026
BMI: Overweight^5	0.000	−0.004 to 0.005	0.001	−0.004 to 0.006
BMI: Obese^5	−0.018	−0.024 to −0.013	−0.018	−0.023 to −0.012
BMI: Morbidly obese^5	−0.039	−0.050 to −0.027	−0.038	−0.049 to −0.026
BMI: Declined to answer^5	−0.018	−0.031 to −0.006	−0.017	−0.030 to −0.005
Current smoker^6	−0.002	−0.007 to 0.002	−0.003	−0.007 to 0.002
Alcohol user^7	−0.014	−0.023 to −0.006	−0.014	−0.023 to −0.006
Morbidity/comorbidity status
Charlson Comorbidity Index	−0.026	−0.028 to −0.023	−0.025	−0.028 to −0.023
Constant	0.704	0.695 to 0.714	0.704	0.694 to 0.713
n	15,070		15,070
Adj R^2	0.205		0.212

Reference categories: ^A no pain reported in last month; ¹ age 18–39 years; ² females; ³ not completed high school; ⁴ income under €20,000; ⁵ BMI normal weight; ⁶ non-smoker; ⁷ non-drinker.

Table 9.  Regression results: Self-reported health status, Germany, 2010.

	Model 1: Pain severity		Model 2: Pain severity and frequency
	Odds ratio	95% CI	Odds ratio	95% CI
Independent variables
Pain level reported in last month^A
Mild	1.672	1.478 to 1.891
Moderate	4.135	3.763 to 4.543
Severe	17.260	14.160 to 21.040
Pain level and frequency^A
Severe daily pain			29.000	23.000 to 36.580
Severe pain 4–6 times a week			10.820	5.815 to 20.130
Severe pain 2–3 times a week			4.481	2.393 to 8.391
Severe pain weekly or less			2.904	1.602 to 5.265
Moderate daily pain			5.964	5.207 to 6.830
Moderate pain 4–6 times a week			5.206	4.186 to 6.473
Moderate pain 2–3 times a week			3.948	3.296 to 4.729
Moderate pain weekly or less			1.981	1.650 to 2.378
Mild daily pain			2.381	1.788 to 3.171
Mild pain 2–6 times a week			2.434	1.973 to 3.003
Mild pain weekly or less			1.168	0.986 to 1.384
Socio-demographic variables
Age: 40–59 years^1	2.074	1.927 to 2.232	1.994	1.853 to 2.147
Age: 60 years and older^1	2.869	2.619 to 3.143	2.710	2.472 to 2.970
Gender: male^2	0.805	0.754 to 0.859	0.814	0.763 to 0.868
Education: High school completed^3	0.863	0.745 to 1.001	0.859	0.741 to 0.996
Education: University or higher^3	0.671	0.577 to 0.781	0.672	0.577 to 0.781
Income: €20,000–€39,999^4	0.773	0.712 to 0.840	0.781	0.719 to 0.848
Income: €40,000 and above^4	0.610	0.553 to 0.673	0.624	0.565 to 0.689
Income reporting declined^4	0.657	0.594 to 0.726	0.667	0.603 to 0.737
Health risk behaviors
BMI: Underweight^5	1.508	1.221 to 1.864	1.506	1.218 to 1.862
BMI: Overweight^5	1.270	1.179 to 1.368	1.251	1.162 to 1.348
BMI: Obese^5	2.310	2.113 to 2.526	2.291	2.095 to 2.505
BMI: Morbidly obese^5	3.585	2.972 to 4.325	3.564	2.952 to 4.304
BMI: Declined to answer^5	2.161	1.759 to 2.655	2.130	1.733 to 2.617
Current smoker^6	1.107	1.031 to 1.187	1.109	1.034 to 1.190
Alcohol user^7	1.270	1.106 to 1.458	1.260	1.096 to 1.447
Morbidity/comorbidity status
Charlson Comorbidity Index	1.773	1.695 to 1.854	1.763	1.685 to 1.844
n	15,070		15,070
Log pseudo likelihood	−16,814.0		−16,710.0
Pseudo R^2	0.128		0.133

Reference categories: ^A no pain reported in last month; ¹ age 18–39 years; ² females; ³ not completed high school; ⁴ income under £20,000; ⁵ BMI normal weight; ⁶ BMI normal weight; ⁷ non-smoker; ⁸ non-drinker.

Table 10.  Regression results: Traditional provider costs, Germany, 2010.

	Model 1: Pain severity		Model 2: Pain severity and frequency
	Coefficient	95% CI	Coefficient	95% CI
Independent variables
Pain level reported in last month^A
Mild	0.201	0.143 to 0.259
Moderate	0.517	0.475 to 0.558
Severe	0.935	0.855 to 1.016
Pain level and frequency^A
Severe daily pain			1.016	0.924 to 1.108
Severe pain 4–6 times a week			0.975	0.707 to 1.243
Severe pain 2–3 times a week			0.615	0.336 to 0.894
Severe pain weekly or less			0.583	0.329 to 0.838
Moderate daily pain			0.637	0.577 to 0.696
Moderate pain 4–6 times a week			0.602	0.504 to 0.700
Moderate pain 2–3 times a week			0.522	0.441 to 0.604
Moderate pain weekly or less			0.210	0.126 to 0.294
Mild daily pain			0.213	0.081 to 0.344
Mild pain 2–6 times a week			0.423	0.325 to 0.520
Mild pain weekly or less			0.051	−0.029 to 0.131
Socio-demographic variables
Age: 40–59 years^1	0.141	0.106 to 0.175	0.124	0.090 to 0.159
Age: 60 years and older^1	0.289	0.247 to 0.331	0.266	0.224 to 0.308
Gender: male^2	−0.182	−0.213 to −0.152	−0.177	−0.208 to −0.146
Education: High school completed^3	−0.084	−0.154 to −0.014	−0.084	−0.154 to −0.015
Education: University or higher^3	−0.110	−0.181 to −0.038	−0.107	−0.178 to −0.036
Income: €20,000–€39,999^4	−0.092	−0.131 to −0.053	−0.087	−0.125 to −0.048
Income: €40,000 and above^4	−0.093	−0.139 to −0.046	−0.081	−0.128 to −0.035
Income reporting declined	−0.154	−0.201 to −0.106	−0.144	−0.192 to −0.097
Health risk behaviors
BMI: Underweight^5	0.056	−0.044 to 0.156	0.054	−0.046 to 0.154
BMI: Overweight^5	0.066	0.030 to 0.101	0.061	0.025 to 0.096
BMI: Obese^5	0.161	0.119 to 0.202	0.155	0.114 to 0.196
BMI: Morbidly obese^5	0.266	0.182 to 0.351	0.262	0.178 to 0.346
BMI: Declined to answer^5	−0.036	−0.134 to 0.064	−0.041	−0.139 to 0.058
Current smoker^6	−0.056	−0.089 to −0.022	−0.054	−0.087 to −0.020
Alcohol user^7	−0.020	−0.085 to 0.045	−0.022	−0.087 to 0.042
Morbidity/comorbidity status
Charlson Comorbidity Index	0.208	0.190 to 0.226	0.204	0.186 to 0.222
Constant	4.789	4.713 to 4.866	4.795	4.719 to 4.871
n	13,118		13,118
Adj R^2	0.174		0.181

Reference categories: ^A no pain reported in last month; ¹ age 18–39 years; ² females; ³ not completed high school; ⁴ income under €20,000; ⁵ BMI normal weight; ⁶ non-smoker; ⁷ non-drinker.

Table 11.  Regression results: Total healthcare costs, Germany, 2010.

	Model 1: Pain severity		Model 2: Pain severity and frequency
	Coefficient	95% CI	Coefficient	95% CI
Independent variables
Pain level reported in last month^A
Mild	0.216	0.143 to 0.289
Moderate	0.589	0.537 to 0.641
Severe	1.177	1.076 to 1.279
Pain level and frequency^A
Severe daily pain			1.239	1.124 to 1.355
Severe pain 4–6 times a week			1.160	0.824 to 1.497
Severe pain 2–3 times a week			1.193	0.843 to 1.544
Severe pain weekly or less			0.790	0.470 to 1.110
Moderate daily pain			0.743	0.669 to 0.818
Moderate pain 4–6 times a week			0.632	0.509 to 0.756
Moderate pain 2–3 times a week			0.614	0.511 to 0.716
Moderate pain weekly or less			0.230	0.125 to 0.336
Mild daily pain			0.197	0.032 to 0.363
Mild pain 2–6 times a week			0.489	0.366 to 0.612
Mild pain weekly or less			0.054	−0.046 to 0.155
Socio-demographic variables
Age: 40–59 years^1	0.077	0.033 to 0.120	0.064	0.020 to 0.107
Age: 60 years and older^1	0.233	0.181 to 0.286	0.212	0.159 to 0.265
Gender: male^2	−0.149	−0.188 to −0.111	−0.146	−0.184 to −0.107
Education: High school completed^3	−0.160	−0.247 to −0.072	−0.143	−0.231 to −0.056
Education: University or higher^3	−0.219	−0.309 to −0.130	−0.199	−0.288 to −0.109
Income: €20,000–€39,999^4	−0.133	−0.181 to −0.084	−0.129	−0.177 to −0.080
Income: €40,000 and above^4	−0.121	−0.179 to −0.062	−0.113	−0.171 to −0.054
Income reporting declined	−0.233	−0.293 to −0.173	−0.226	−0.286 to −0.166
Health risk behaviors
BMI: Underweight^5	0.099	−0.027 to 0.225	0.100	−0.025 to 0.225
BMI: Overweight^5	0.088	0.043 to 0.132	0.085	0.040 to 0.129
BMI: Obese^5	0.157	0.105 to 0.209	0.154	0.102 to 0.205
BMI: Morbidly obese^5	0.283	0.177 to 0.389	0.283	0.177 to 0.388
BMI: Declined to answer^5	−0.035	−0.159 to 0.089	−0.059	−0.183 to 0.065
Current smoker^6	−0.086	−0.128 to −0.044	−0.080	−0.122 to −0.038
Alcohol user^7	0.025	−0.056 to 0.106	0.024	−0.057 to 0.105
Morbidity/comorbidity status
Charlson Comorbidity Index	0.280	0.257 to 0.302	0.276	0.253 to 0.298
Constant	5.080	4.985 to 5.176	5.063	4.967 to 5.158
n	13,156		13,118
Adj R^2	0.158		0.166

Reference categories: ^A no pain reported in last month; ¹ age 18–39 years; ² females; ³ not completed high school; ⁴ income under €20,000; ⁵ BMI normal weight; ⁶ non-smoker; ⁷ non-drinker.