Comparison of health-care utilization, costs and health-related quality of life across the subgroups defined by the Keele STarT MSK Tool

Rheumatology (Oxford). 2023 Jun 1;62(6):2076-2082. doi: 10.1093/rheumatology/keac560.

Abstract

Objectives: The aim of this study was to describe and compare health economic outcomes [health-care utilization and costs, work outcomes, and health-related quality of life (EQ-5D-5L)] in patients classified into different levels-of-risk subgroups by the Keele STarT MSK Tool.

Methods: Data on health-care utilization, costs and EQ-5D-5L were collected from a health-care perspective within a primary care prospective observational cohort study. Patients presenting with one (or more) of the five most common musculoskeletal pain presentations were included: back, neck, shoulder, knee or multi-site pain. Participants at low, medium and high risk of persistent disabling pain were compared in relation to mean health-care utilization and costs, health-related quality of life, and employment status. Regression analysis was used to estimate costs.

Results: Over 6 months, the mean (s.d.) total health-care (National Health Service and private) costs associated with the low, medium, and high-risk subgroups were £132.92 (167.88), £279.32 (462.98) and £476.07 (716.44), respectively. Mean health-related quality of life over the 6-month period was lower and more people changed their employment status in the high-risk subgroup compared with the medium- and low-risk subgroups.

Conclusions: This study demonstrates that subgroups of people with different levels of risk for poor musculoskeletal pain outcomes also have different levels of health-care utilization, health-care costs, health-related quality of life, and work outcomes. The findings show that the STarT MSK Tool not only identifies those at risk of a poorer outcome, but also those who will have more health-care visits and incur higher costs.

Keywords: EQ-5D; costs; musculoskeletal pain; stratified care.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Musculoskeletal Pain* / therapy
  • Patient Acceptance of Health Care
  • Prospective Studies
  • Quality of Life*
  • State Medicine