For a study, researchers sought to investigate the scope and expenditures of ambulatory primary care, specialty physician care, and hospital service utilization for musculoskeletal diseases (MSDs) in Ontario, Canada’s biggest province.

Administrative health databases for individuals aged 18 years were examined for the fiscal year 2013-2014, including data on physician services, emergency department (ED) visits, and hospitalizations. MSD services were identified using the International Classification of Diseases diagnosis codes. To assess direct medical expenditures, a proven technique was utilized. Person-visit rates and total visits were calculated based on care environment, age, gender, and physician specialization. Data for all MSDs were analyzed, as well as particular diagnostic groups.

Overall, almost 8 million outpatient physician visits for MSDs were made by 3.1 million adult Ontarians (28.5%). There were 5.6 million primary care visits among them. MSDs accounted for 560,000 (12.3%) of all adult ED visits. Total MSD-related treatment costs $1.6 billion, with primary care accounting for 12.6% of expenses, specialist care accounting for 9.2%, ED care accounting for 8.6%, day surgery accounting for 8.5%, and inpatient stays accounting for 61.2%. Arthritis expenditures represented 40% of overall MSD care costs ($639 million). MSD-related imaging expenditures were $169 million, for a total estimated cost of $1.8 billion for MSDs.

MSDs impose a substantial and costly burden on the healthcare system. To lower both the individual and population burden, health system design must consider the huge and increasing demand for treatment.

Reference: jrheum.org/content/49/7/740