Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute, Toronto, Ontario, Canada.
Arthritis Care Res (Hoboken). 2010 Feb;62(2):161-9. doi: 10.1002/acr.20064.
OBJECTIVE: To examine patterns of ambulatory care and hospital utilization for people with musculoskeletal disorders (MSDs), including arthritis and related conditions, bone and spinal conditions, trauma and related conditions, and unspecified MSDs. METHODS: Administrative data from the Ontario Health Insurance Plan database for ambulatory care physician visits, the National Ambulatory Care Reporting System database for day (outpatient) surgeries and emergency department visits, and the Discharge Abstract Database for hospital discharges were used to examine health care utilization for MSDs in fiscal year 2006-2007. Person visit rates (number of people with physician visits or hospital encounters per population) were calculated. RESULTS: Overall, 22.3% of Ontario's population (2.8 million persons) saw a physician for an MSD in ambulatory settings. Person visit rates were highest for arthritis and related conditions (107.7 per 1,000 population), followed by trauma and related conditions (89.6 per 1,000 population), unspecified MSDs (71.0 per 1,000 population), and bone and spinal conditions (62.4 per 1,000 population). The majority of visits were to primary care physicians, with 83.2% of those with visits for all MSDs seeing a primary care physician at least once. Overall, 33.0% of people with a physician visit for an MSD saw a specialist, with orthopedic surgeons being the most commonly consulted type of specialist. In hospital settings, person visit rates for MSDs were highest in the emergency department, followed by day surgeries and inpatient hospitalizations. CONCLUSION: The findings of our study highlight the magnitude of health care utilization for MSDs and the central role of primary care physicians in the management of these conditions.
目的:研究患有肌肉骨骼疾病(MSD),包括关节炎和相关疾病、骨骼和脊柱疾病、创伤和相关疾病以及未指明的 MSD 的患者的门诊护理和住院利用模式。
方法:使用安大略省医疗保险计划数据库中的门诊医生就诊、国家门诊护理报告系统数据库中的日间(门诊)手术和急诊就诊以及出院摘要数据库中的住院出院数据,研究 2006-2007 财政年度 MSD 的医疗保健利用情况。计算了就诊率(每千人口中有医生就诊或住院的人数)。
结果:总体而言,安大略省 22.3%的人口(280 万人)在门诊环境中因 MSD 看医生。关节炎和相关疾病的就诊率最高(每千人口 107.7 次),其次是创伤和相关疾病(每千人口 89.6 次)、未指明的 MSD(每千人口 71.0 次)和骨骼和脊柱疾病(每千人口 62.4 次)。大多数就诊是看初级保健医生,所有 MSD 就诊中有 83.2%的人至少看过一次初级保健医生。总体而言,33.0%的 MSD 就诊者看了专科医生,骨科医生是最常咨询的专科医生类型。在医院环境中,MSD 的就诊率在急诊部最高,其次是日间手术和住院治疗。
结论:我们的研究结果突出了 MSD 医疗保健利用的规模以及初级保健医生在这些疾病管理中的核心作用。
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