Ambulatory physician care for musculoskeletal disorders in Canada

To examine patterns of ambulatory physician visits for musculoskeletal disorders (MSD) in Canada.

Physician claims data from 7 provinces were analyzed for ambulatory visits made by adults age >or= 15 years to primary care physicians and specialists (all medical specialists, rheumatologists, internists, all surgical specialists, orthopedic surgeons) for MSD (arthritis and related conditions, bone disorders, back disorders, ill defined symptoms) during fiscal year 1998-99. Person-visit rates and total and mean number of visits to all physicians for MSD were calculated by condition group. The percentages of patients with MSD seeing physicians of different specialties were also calculated. Provincial data were combined to calculate national estimates.

Over 15.5 million physician visits were made for MSD during 1998-99. About 24% of Canadians made at least one physician visit for MSD: 16% for arthritis and related conditions, 2% for bone disorders, 7% for back disorders, and 6% for ill defined symptoms. Person-visit rates for MSD varied by province, were highest among older Canadians, and were greater for women than men. Primary care physicians were commonly seen, particularly for back disorders. Consultation with surgical and medical specialists was less common and varied by province and by condition.

MSD place a significant burden on Canada's ambulatory healthcare system. As the population ages, there will be an escalating demand for care. Careful planning will be required to ensure that those affected have access to the care they require. A limitation in using administrative data to examine health service utilization is that MSD diagnostic codes require validation.