Healthcare Utilization and Costs for Musculoskeletal Disorders in Ontario, Canada

J Denise Power; Anthony V Perruccio; J Michael Paterson; Mayilee Canizares; Christian Veillette; Peter C Coyte; Elizabeth M Badley; Nizar N Mahomed; Y Raja Rampersaud

doi:10.3899/jrheum.210938

Healthcare Utilization and Costs for Musculoskeletal Disorders in Ontario, Canada

J Rheumatol. 2022 Jul;49(7):740-747. doi: 10.3899/jrheum.210938. Epub 2022 Apr 1.

Authors

J Denise Power¹, Anthony V Perruccio², J Michael Paterson³, Mayilee Canizares⁴, Christian Veillette⁵, Peter C Coyte⁶, Elizabeth M Badley⁷, Nizar N Mahomed⁵, Y Raja Rampersaud⁵

Affiliations

¹ J.D. Power, PhD, M. Canizares, PhD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto; dpower@uhnres.utoronto.ca.
² A.V. Perruccio, PhD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto.
³ J.M. Paterson, MSc, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, and ICES, Toronto.
⁴ J.D. Power, PhD, M. Canizares, PhD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto.
⁵ C. Veillette, MD, MSc, N.N. Mahomed, MD, ScD, Y.R. Rampersaud, MD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, and Orthopaedics, Department of Surgery, University of Toronto, Toronto.
⁶ P.C. Coyte, PhD, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto.
⁷ E.M. Badley, PhD, Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.

PMID: 35365584
DOI: 10.3899/jrheum.210938

Abstract

Objective: To examine the magnitude and costs of ambulatory primary care, specialist physician care, and hospital service use for musculoskeletal disorders (MSDs) in Canada's largest province, Ontario.

Methods: Administrative health databases were analyzed for fiscal year 2013-2014 for adults aged ≥ 18 years, including data on physician services, emergency department (ED) visits, and hospitalizations. International Classification of Diseases diagnostic codes were used to identify MSD services. A validated algorithm was used to estimate direct medical costs. Person-visit rates and numbers of persons and visits were tabulated by care setting, age, sex, and physician specialty. Data were examined for all MSDs combined, as well as for specific diagnostic groupings.

Results: Overall, 3.1 million adult Ontarians (28.5%) made over 8 million outpatient physician visits associated with MSDs. These included 5.6 million primary care visits. MSDs accounted for 560,000 (12.3%) of all adult ED visits. Total costs for MSD-related care were $1.6 billion, with 12.6% of costs attributed to primary care, 9.2% to specialist care, 8.6% to ED care, 8.5% to day surgery, and 61.2% associated with inpatient hospitalizations. Costs due to arthritis accounted for 40% of total MSD care costs ($639 million). MSD-related imaging costs were $169 million, yielding a total cost estimate of $1.8 billion for MSDs overall.

Conclusion: MSDs place a significant and costly burden on the healthcare system. Health system planning needs to consider the large and escalating demand for care to reduce both the individual and population burden.

Keywords: arthritis; health services; healthcare costs; musculoskeletal diseases.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Ambulatory Care
Delivery of Health Care*
Emergency Service, Hospital
Health Care Costs
Hospitalization
Humans
Musculoskeletal Diseases* / epidemiology
Musculoskeletal Diseases* / therapy
Ontario / epidemiology
Patient Acceptance of Health Care