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

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

doi:10.1080/03007995.2023.2271862

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

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

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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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.

Original language	English
Number of pages	8
Journal	Current Medical Research and Opinion
Early online date	19 Oct 2023
DOIs	https://doi.org/10.1080/03007995.2023.2271862
Publication status	Early online date - 19 Oct 2023

Bibliographical note

Funding Information:
The Keele School of Medicine has received funding from the British Medical Society for a non-pharmacological atrial fibrillation screening trial. The authors have no further conflicts to declare.

Publisher Copyright:
© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Keywords

comorbidity
Cost
musculoskeletal
pain

ASJC Scopus subject areas

General Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1080/03007995.2023.2271862Licence: CC BY-NC-ND

Estimating the direct healthcare utilization and cost of musculoskeletal pain among people with comorbidity: a retrospective electronic health record study
Copyright 2023 the authors. This is an open access article published under a Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits distribution and reproduction for non-commercial purposes, provided the author and source are cited.
Final published version, 1.09 MBLicence: CC BY-NC-ND

Cite this

Png, M. E., Mason, K. J., Marshall, M., Jordan, K. P., Bailey, J., Frisher, M., Heron, N., Huntley, A. L., Mallen, C. D., Mamas, M. A., Tatton, S., White, S., Edwards, J. J., & Achana, F. (2023). Estimating the direct healthcare utilization and cost of musculoskeletal pain among people with comorbidity: a retrospective electronic health record study. Current Medical Research and Opinion. Advance online publication. https://doi.org/10.1080/03007995.2023.2271862

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

abstract = "ObjectiveTo 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.MethodsUsing 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.ResultsThe 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.ConclusionThis 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.",

keywords = "comorbidity, Cost, musculoskeletal, pain",

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

note = "Funding Information: The Keele School of Medicine has received funding from the British Medical Society for a non-pharmacological atrial fibrillation screening trial. The authors have no further conflicts to declare. Publisher Copyright: {\textcopyright} 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.",

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Png, ME, Mason, KJ, Marshall, M, Jordan, KP, Bailey, J, Frisher, M, Heron, N, Huntley, AL, Mallen, CD, Mamas, MA, Tatton, S, White, S, Edwards, JJ & Achana, F 2023, 'Estimating the direct healthcare utilization and cost of musculoskeletal pain among people with comorbidity: a retrospective electronic health record study', Current Medical Research and Opinion. https://doi.org/10.1080/03007995.2023.2271862

TY - JOUR

T1 - Estimating the direct healthcare utilization and cost of musculoskeletal pain among people with comorbidity: a retrospective electronic health record study

AU - Png, May Ee

AU - Mason, Kayleigh J.

AU - Marshall, Michelle

AU - Jordan, Kelvin P.

AU - Bailey, James

AU - Frisher, Martin

AU - Heron, Neil

AU - Huntley, Alyson L.

AU - Mallen, Christian D.

AU - Mamas, Mamas A.

AU - Tatton, Stephen

AU - White, Simon

AU - Edwards, John J.

AU - Achana, Felix

N1 - Funding Information: The Keele School of Medicine has received funding from the British Medical Society for a non-pharmacological atrial fibrillation screening trial. The authors have no further conflicts to declare. Publisher Copyright: © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

PY - 2023/10/19

Y1 - 2023/10/19

N2 - ObjectiveTo 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.MethodsUsing 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.ResultsThe 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.ConclusionThis 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.

AB - ObjectiveTo 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.MethodsUsing 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.ResultsThe 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.ConclusionThis 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.

KW - comorbidity

KW - Cost

KW - musculoskeletal

KW - pain

U2 - 10.1080/03007995.2023.2271862

DO - 10.1080/03007995.2023.2271862

M3 - Article

C2 - 37853741

SN - 0300-7995

JO - Current Medical Research and Opinion

JF - Current Medical Research and Opinion

ER -

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

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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