THE COSTS OF MUSCULOSKELETAL DISEASE: HEALTH NEEDS ASSESSMENT AND HEALTH ECONOMICS

The Costs Of Musculoskeletal Disease: Health Needs Assessment And Health Economics

The Costs Of Musculoskeletal Disease: Health Needs Assessment And Health Economics

The Costs Of Musculoskeletal Disease: Health Needs Assessment And Health Economics

Introduction

Arthritis and musculoskeletal diseases dominate the national illness burden. They are the most prevalent of health problems in the UK, affecting over 40 million people aged 45 years and older and are projected to affect more than 60 million persons, or 22% of the population, in the year 2030. While mortality from these conditions is low, they have a major affect on disability, medical costs and patient quality of life. As the average age of the population rises, the impact of musculoskeletal conditions on society will increase in parallel.

The way in which musculoskeletal disease affects an individual is a function of the severity of the condition, the characteristics of the individual and the length of time with the condition. Patient factors that also affect the outcome of disease include: age, gender, lifestyle and preferences for specific outcomes. Over the past 20 years, assessment of patient health outcomes has moved from a focus on clinical parameters, such as sedimentation rate or radiographs, to an emphasis on outcomes based on the patient's personal assessment of their health status. Specific instruments have been developed for this purpose.

Due to the significant economic and individual effects of arthritis and musculoskeletal disease, these conditions have become a focus of strategies to reduce disability and prevent the occurrence and progression of arthritis. In this chapter, I discuss general terminology regarding the 'costs' of musculoskeletal disease, present data on their severity, and discuss the implications for clinical care to provide a context for understanding the large burden of health needs assessment.

Analysis & Discussion

The costs of illness are generally divided into three categories: direct costs, indirect costs and intangible costs. Direct costs include expenditure for medical care and related items. These include expenditure for physician visits, diagnostic tests, prescription and over-the-counter medications, hospital stays, aids and devices, and outpatient surgical procedures. All of this expenditure may be borne solely or in combination by the patient, his or her health insurer, an employer or a federal or state government entity. Direct costs also include other expenditure, generally paid for by the patient, such as transportation to and from the doctor or other allied health worker, higher food bills associated with a special diet, or expenditure to adapt the home environment to make functioning easier. Direct costs can be measured in many ways, including counting the number of healthcare services used and assigning a standard charge per service, obtaining billing or insurance records for the actual amounts charged for each service, or the amount reimbursed by the insurance company.

Indirect costs are those resulting from lost function in one's usual activity, including work disability, sick leave or reduced productivity associated with a reduction in work hours or a need to change the nature of one's work to reduce pain and improve physical ...