Estimating the direct healthcare utilization and cost of musculoskeletal pain among people with comorbidity: a retrospective electronic health record study

Png, May Ee; Mason, Kayleigh J.; Marshall, Michelle; Jordan, Kelvin P.; Bailey, James; Frisher, Martin; Heron, Neil; Huntley, Alyson L.; Mallen, Christian D.; Mamas, Mamas A.; Tatton, Stephen; White, Simon; Edwards, John J.; Achana, Felix

Abstract

Objective
To investigate the impact of pre-existing painful musculoskeletal conditions on healthcare utilization and costs among patients with five common conditions: acute coronary syndrome (ACS), stroke, cancer, dementia and pneumonia.

Methods
Using primary and secondary care services data from electronic health records, a negative binomial regression model was used to compare resource use while a two-part model was used to compare costs across the five conditions, between those with and without a pre-existing musculoskeletal pain.

Results
The study included 760,792 patients (144,870 with ACS, 121,208 with stroke, 231,702 with cancer, 134,638 with dementia, and 128,374 with pneumonia) in the complete case analysis. Pre-existing musculoskeletal pain had an incident rate ratio of above one for most healthcare resources over the follow-up period and an adjusted additional mean cumulative total healthcare costs per patient of £674.59 (95%CI 570.30 to 778.87) for ACS; £613.34 (95%CI 496.87 to 729.82) for stroke; £459.26 (95%CI 376.60 to 541.91) for cancer; and £766.23 (95%CI 655.06 to 877.39) for dementia over five years after diagnosis; and £200.85 (95%CI 104.16 to 297.55) for pneumonia over one year after diagnosis compared to those without musculoskeletal pain.

Conclusion
This study highlights that individuals with painful musculoskeletal conditions have higher healthcare utiliszation and costs than those without painful musculoskeletal conditions. Given the high occurrence of musculoskeletal pain in patients with other conditions, effective management strategies are needed to reduce the burden on healthcare resources.

• Journal Article Type: Article
• Acceptance Date: Oct 13, 2023
• Online Publication Date: Oct 19, 2023
• Publication Date: Oct 19, 2023
• Deposit Date: Oct 26, 2023
• Journal: Current Medical Research and Opinion
• Print ISSN: 0300-7995
• Electronic ISSN: 1473-4877
• Publisher: Taylor and Francis
• Peer Reviewed: Peer Reviewed
• Pages: 1-8
• DOI: https://doi.org/10.1080/03007995.2023.2271862
• Keywords: General Medicine, Cost, pain, musculoskeletal, comorbidity
• Publisher URL: https://www.tandfonline.com/doi/full/10.1080/03007995.2023.2271862
• Additional Information: Peer Review Statement: The publishing and review policy for this title is described in its Aims & Scope.; Aim & Scope: http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=icmo20; Received: 2023-06-21; Accepted: 2023-10-13; Published: 2023-10-19