Combination of health care service use and the relation to demographic and socioeconomic factors for patients with musculoskeletal disorders: a descriptive cohort study
Abstract Background Patients with musculoskeletal disorders (MSDs) access health care in different ways. Despite the high prevalence and significant costs, we know little about the different ways patients use health care. We aim to fill this gap by identifying which combinations of health care servi...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-09852-3 |
| _version_ | 1797453448090746880 |
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| author | Olav Amundsen Tron Anders Moger Jon Helgheim Holte Silje Bjørnsen Haavaag Line Kildal Bragstad Ragnhild Hellesø Trond Tjerbo Nina Køpke Vøllestad |
| author_facet | Olav Amundsen Tron Anders Moger Jon Helgheim Holte Silje Bjørnsen Haavaag Line Kildal Bragstad Ragnhild Hellesø Trond Tjerbo Nina Køpke Vøllestad |
| author_sort | Olav Amundsen |
| collection | DOAJ |
| description | Abstract Background Patients with musculoskeletal disorders (MSDs) access health care in different ways. Despite the high prevalence and significant costs, we know little about the different ways patients use health care. We aim to fill this gap by identifying which combinations of health care services patients use for new MSDs, and its relation to clinical characteristics, demographic and socioeconomic factors, long-term use and costs, and discuss what the implications of this variation are. Methods The study combines Norwegian registers on health care use, diagnoses, comorbidities, demographic and socioeconomic factors. Patients (≥ 18 years) are included by their first health consultation for MSD in 2013–2015. Latent class analysis (LCA) with count data of first year consultations for General Practitioners (GPs), hospital consultants, physiotherapists and chiropractors are used to identify combinations of health care use. Long-term high-cost patients are defined as total cost year 1–5 above 95th percentile (≥ 3 744€). Results We identified seven latent classes: 1: GP, low use; 2: GP, high use; 3: GP and hospital; 4: GP and physiotherapy, low use; 5: GP, hospital and physiotherapy, high use; 6: Chiropractor, low use; 7: GP and chiropractor, high use. Median first year health care contacts varied between classes from 1–30 and costs from 20€-838€. Eighty-seven percent belonged to class 1, 4 or 6, characterised by few consultations and treatment in primary care. Classes with high first year use were characterised by higher age, lower education and more comorbidities and were overrepresented among the long-term high-cost users. Conclusion There was a large variation in first year health care service use, and we identified seven latent classes based on frequency of consultations. A small proportion of patients accounted for a high proportion of total resource use. This can indicate the potential for more efficient resource use. However, the effect of demographic and socioeconomic variables for determining combinations of service use can be interpreted as the health care system transforming unobserved patient needs into variations in use. These findings contribute to the understanding of clinical pathways and can help in the planning of future care, reduction in disparities and improvement in health outcomes for patients with MSDs. |
| first_indexed | 2024-03-09T15:22:58Z |
| format | Article |
| id | doaj.art-f931641092474972813925d214636af4 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-09T15:22:58Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-f931641092474972813925d214636af42023-11-26T12:43:26ZengBMCBMC Health Services Research1472-69632023-08-0123111610.1186/s12913-023-09852-3Combination of health care service use and the relation to demographic and socioeconomic factors for patients with musculoskeletal disorders: a descriptive cohort studyOlav Amundsen0Tron Anders Moger1Jon Helgheim Holte2Silje Bjørnsen Haavaag3Line Kildal Bragstad4Ragnhild Hellesø5Trond Tjerbo6Nina Køpke Vøllestad7Dept. for Interdisciplinary Health Sciences, Institute of Health and Society, University of OsloDept. of Health Management and Health Economics, Institute of Health and Society, University of OsloDept. of Health Management and Health Economics, Institute of Health and Society, University of OsloDept. of Public Health Science, Institute of Health and Society, University of OsloDept. of Public Health Science, Institute of Health and Society, University of OsloDept. of Public Health Science, Institute of Health and Society, University of OsloDept. of Health Management and Health Economics, Institute of Health and Society, University of OsloDept. for Interdisciplinary Health Sciences, Institute of Health and Society, University of OsloAbstract Background Patients with musculoskeletal disorders (MSDs) access health care in different ways. Despite the high prevalence and significant costs, we know little about the different ways patients use health care. We aim to fill this gap by identifying which combinations of health care services patients use for new MSDs, and its relation to clinical characteristics, demographic and socioeconomic factors, long-term use and costs, and discuss what the implications of this variation are. Methods The study combines Norwegian registers on health care use, diagnoses, comorbidities, demographic and socioeconomic factors. Patients (≥ 18 years) are included by their first health consultation for MSD in 2013–2015. Latent class analysis (LCA) with count data of first year consultations for General Practitioners (GPs), hospital consultants, physiotherapists and chiropractors are used to identify combinations of health care use. Long-term high-cost patients are defined as total cost year 1–5 above 95th percentile (≥ 3 744€). Results We identified seven latent classes: 1: GP, low use; 2: GP, high use; 3: GP and hospital; 4: GP and physiotherapy, low use; 5: GP, hospital and physiotherapy, high use; 6: Chiropractor, low use; 7: GP and chiropractor, high use. Median first year health care contacts varied between classes from 1–30 and costs from 20€-838€. Eighty-seven percent belonged to class 1, 4 or 6, characterised by few consultations and treatment in primary care. Classes with high first year use were characterised by higher age, lower education and more comorbidities and were overrepresented among the long-term high-cost users. Conclusion There was a large variation in first year health care service use, and we identified seven latent classes based on frequency of consultations. A small proportion of patients accounted for a high proportion of total resource use. This can indicate the potential for more efficient resource use. However, the effect of demographic and socioeconomic variables for determining combinations of service use can be interpreted as the health care system transforming unobserved patient needs into variations in use. These findings contribute to the understanding of clinical pathways and can help in the planning of future care, reduction in disparities and improvement in health outcomes for patients with MSDs.https://doi.org/10.1186/s12913-023-09852-3Health care utilizationMusculoskeletalRegister-based research |
| spellingShingle | Olav Amundsen Tron Anders Moger Jon Helgheim Holte Silje Bjørnsen Haavaag Line Kildal Bragstad Ragnhild Hellesø Trond Tjerbo Nina Køpke Vøllestad Combination of health care service use and the relation to demographic and socioeconomic factors for patients with musculoskeletal disorders: a descriptive cohort study BMC Health Services Research Health care utilization Musculoskeletal Register-based research |
| title | Combination of health care service use and the relation to demographic and socioeconomic factors for patients with musculoskeletal disorders: a descriptive cohort study |
| title_full | Combination of health care service use and the relation to demographic and socioeconomic factors for patients with musculoskeletal disorders: a descriptive cohort study |
| title_fullStr | Combination of health care service use and the relation to demographic and socioeconomic factors for patients with musculoskeletal disorders: a descriptive cohort study |
| title_full_unstemmed | Combination of health care service use and the relation to demographic and socioeconomic factors for patients with musculoskeletal disorders: a descriptive cohort study |
| title_short | Combination of health care service use and the relation to demographic and socioeconomic factors for patients with musculoskeletal disorders: a descriptive cohort study |
| title_sort | combination of health care service use and the relation to demographic and socioeconomic factors for patients with musculoskeletal disorders a descriptive cohort study |
| topic | Health care utilization Musculoskeletal Register-based research |
| url | https://doi.org/10.1186/s12913-023-09852-3 |
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