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Prevalence and Cost of Musculoskeletal Disorders:
A Population-based, Public Hospital System Healthcare Consumption Approach
RICHARD H. OSBORNE, MANDANA NIKPOUR, LUCY BUSIJA, VIJAYA SUNDARARAJAN, and IAN P. WICKS
ABSTRACT. Methods. A healthcare utilization survey of 4 million individual records over 4 years, from all major public hospitals in the state of Victoria (estimated population 4.8 million residents in 2000/01) from 1997/98 to 2000/01. Main outcome measures were inpatient episodes of care, bed-days, and outpatient clinic encounters. MSD was defined as the combination of orthopedics and rheumatology. Results. After obstetrics, MSD was the most frequent outpatient service, with orthopedics accounting for 9.9% of all visits in 2000/01. The proportion of MSD outpatient encounters (on average 11.6% of the total) was constant over the study period. Among 26 medical specialties, MSD had the sixth highest number of inpatient episodes (6.2% in 2000/01), following renal dialysis (14.6%), general surgery (8.2%), obstetrics (7.6%), gastroenterology (7.1%), and general medicine (6.7%). MSD was the fifth highest consumer of bed-days, occupying on average 7.7% of all beds per annum in the period 1997/98 to 2000/01, behind psychiatry (10.1%), respiratory medicine (8.5%), rehabilitation (8.3%), and general medicine (7.8%). MSD was the third most-costly discipline in 2000/01, with total costs of over A$169 million (9.7% of total inpatient costs that year), behind respiratory medicine (11.6%) and general surgery (11.5%). Conclusion. Compared to other diseases, MSD consumes a substantial proportion of healthcare resources in Victorian public hospitals. These data have important implications for allocation of healthcare resources, clinical care pathways, and prevention strategies. (First Release Nov 1 2007; J Rheumatol 2007;34:2466-75) Key Indexing Terms:
MUSCULOSKELETAL DISEASES
From the Centre for Rheumatic Diseases, Department of Medicine, and Clinical Epidemiology and Health Evaluation Unit, Royal Melbourne Hospital, The University of Melbourne; Health Surveillance and Evaluation Section, Rural and Regional Health and Aged Care Services, Department of Human Services, Victoria, Australia; and Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada. Dr. Osborne's work was supported in part by the Baker Trust, Buckland Foundation, Arthritis Foundations of Victoria and Australia, and by a National Health and Medical Research Council (NHMRC) of Australia Population Health Career Development Award. Prof. Wicks is supported by an NMHRC Clinical Practitioner Fellowship. R.H. Osborne, BSc, PhD, NHMRC Population Health Fellow, Senior Lecturer; L. Busija, BA, MSci, Research Officer; I.P. Wicks, MBBS, FRACP, PhD, Professor/Director of Rheumatology, Centre for Rheumatic Diseases, Department of Medicine, Royal Melbourne Hospital, The University of Melbourne; M. Nikpour, MBBS, FRACP, FRCPA, Clinical Research Fellow, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University Health Network; V. Sundararajan, MD, MPH, FACP, Senior Epidemiologist, Health Surveillance and Evaluation Section, Rural and Regional Health and Aged Care Services, Department of Human Services, Victoria, and Health Evaluation Unit, Royal Melbourne Hospital. Drs. Osborne and Nikpour contributed equally to the manuscript and are equal first authors. Address reprint requests to Prof. I. Wicks, Centre for Rheumatic Diseases, Department of Medicine, The University of Melbourne, Royal Melbourne Hospital, Victoria, 3050 Australia. E-mail: ian.wicks@mh.org.au Accepted for publication July 6, 2007. |
