Musculoskeletal conditions should be prioritised by policy makers to address their impact on health care expenditure
A new study presented at the European League Against Rheumatism Annual Congress (EULAR 2014) highlights the increased health care costs associated with musculoskeletal conditions compared to other diseases. Health care costs were almost 50% higher for people with a musculoskeletal condition compared to any other singly occurring condition.1
This disparity remained high where two conditions co-existed, with health care costs still one third higher (36%) for those people with one of their two conditions musculoskeletal in nature, highlighting the significant impact of these diseases.1
In Europe, 70-80% of all health care costs relate to chronic diseases, a large proportion of which are musculoskeletal conditions. This study showed a steep increase in health care costs as the number of diseases (morbidities) in a single patient increased. Interestingly, musculoskeletal conditions had a larger impact on health care costs than any other diseases, whether occurring alone or as co-morbidity.1
"It is clear that the cost of delivering care to those patients with musculoskeletal conditions is considerably higher than those with other diseases. In these economically challenging times, this research highlights a clear area of focus for policy makers where prioritisation of musculoskeletal disorders could result in longer term cost efficiencies," said Dr Anjte Van Der Zee-Neuen of the Division of Rheumatology, Maastricht University, The Netherlands.
More than 150 conditions affect the muscles, bones, and joints, and these are collectively described as musculoskeletal conditions.2 They are a common group of conditions affecting up to 20% of adults.1 ,3 Their prevalence increases considerably with age making them the main cause of disability among the elderly.3
This Dutch cross-sectional study of 8,904 people assessed how the number of diseases an individual has impacts on their total health care cost, and which combinations of diseases have the greater impact on cost.
The study collated individuals self-reported physician-diagnosed diseases, including musculoskeletal conditions, diabetes, cardiovascular diseases, cancer, migraine, respiratory, skin, mental and bowel conditions, along with their healthcare usage. Total health care costs were calculated for a three-month period using reference prices from the Dutch manual for pharmaco-economic health care evaluations 2010, adjusting for inflation as required and using healthy individuals as the reference point.
More than one disease diagnosis, known as multi-morbidity, was present in almost 20% of cases (1,722), with 20% (1,766) of people reported to have a musculoskeletal condition. The health care costs increased steeply as the number of diseases in an individual increased, but the presence of musculoskeletal conditions had a larger impact on the total cost than any other condition. When two diseases were present in an individual, neither of which were musculoskeletal conditions, their healthcare costs were two times higher than a healthy person. However, if one of the two diseases was a musculoskeletal condition, the health care costs were three times higher than for a healthy person.