Prevalence and cost of musculoskeletal disorders: a population-based, public hospital system healthcare consumption approach.
OBJECTIVE
To use a population-level, public-hospital approach to compare the prevalence and cost of musculoskeletal diseases (MSD) with other clinical specialties.


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 dollars 169 million (9.7% of total inpatient costs that year), behind respiratory medicine (11.6%) and general surgery (11.5%).


CONCLUSIONS
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.
Osborne
Richard H
RH
Centre for Rheumatic Diseases, Department of Medicine, and Clinical Epidemiology and Health Evaluation Unit, Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia.
Nikpour
Mandana
M
Busija
Lucy
L
Sundararajan
Vijaya
V
Wicks
Ian P
IP
D003361:Cost Allocation; D017050:Episode of Care; D005260:Female; D017721:Hospital Costs; D006779:Hospitals, Public / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D009140:Musculoskeletal Diseases / Q000191:economics* / Q000453:epidemiology*; D010044:Outpatient Clinics, Hospital / Q000191:economics / Q000706:statistics & numerical data; D015995:Prevalence; D014600:Utilization Review; D014739:Victoria / Q000453:epidemiology