Disability, utilization, and costs associated with musculoskeletal conditions

In this report, data from the 1980 National Medical Care Utilization and Expenditure Survey are used to present health characteristics, types and quantities of services used, and the charges for these services for persons with musculoskeletal diseases. Slightly more than 44 million people, or 19.8 percent of the U.S. civilian noninstitutionalized population, were reported in the survey to have at least one musculoskeletal disorder. These data are generally consistent with those from other health surveys, which show that the prevalence of musculoskeletal disorders increases for successive age categories, that such disorders are more common among women than among men, and that they are less prevalent among black persons than among persons of other races. In terms of both functional limitation and perceived health status, persons with musculoskeletal conditions are, with some notable exceptions, in relatively poor health. Persons having back problems in addition to problems with peripheral joints (such as the knee, hip, or shoulder) were more likely to rate their health as "fair" or "poor" compared with persons having only back problems or compared with persons in the civilian noninstitutionalized population as a whole. Musculoskeletal disorders accounted for a considerable proportion of all disability days reported by the total civilian noninstitutionalized population: 13 percent of restricted-activity days, 8.8 percent of bed-disability days, and 11.2 percent of all work-loss days were directly attributable to musculoskeletal conditions. The disabling effects of musculoskeletal problems pose a significant economic burden; they accounted for a total of $3.9 billion in lost productivity costs during 1980 for employed persons in the work force and for homemakers. For persons with musculoskeletal problems, the mean number of ambulatory visits per year was nearly twice the rate of 5.2 for the general civilian noninstitutionalized population. Of ambulatory visits made to all health care providers by persons with these conditions, 35.6 percent were related in some way to the treatment of their musculoskeletal problems. Musculoskeletal conditions are somewhat different from many other illnesses because their treatment is within the professional domain of several types of health care providers. Approximately 13 percent of persons with any type of musculoskeletal disorder received care from chiropractors during the year and this figure rose to nearly 30 percent for back problems only. However, nearly 33 percent of persons with musculoskeletal problems made no visits for treatment of their condition.(ABSTRACT TRUNCATED AT 400 WORDS)