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- Title
Consumption of medical resources and outcome of shoulder disorders in primary health care consulters.
- Authors
Paloneva, Juha; Koskela, Sanna; Kautiainen, Hannu; Vanhala, Mauno; Kiviranta, Ilkka
- Abstract
Background Shoulder disorders are common problems in primary health care. The course of disease of patients consulting for a new episode of a shoulder problem has been thought to be benign. In this prospective cohort study, we assessed the one-year consumption of medical resources and clinical outcome of shoulder disorders inclusive of all disease episodes. Methods All individuals consulting primary health care for shoulder disorder in a catchment area of more than 120 000 people were included. A composite questionnaire including the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) was used to measure use of resources as well as shoulder pain and function. A follow-up assessment was performed after one year. Results A total of 128 individuals responded to the questionnaire. Only 24% of the patients had recovered after one year. Mean shoulder pain (Visual analogue scale, VAS, max 100 mm) decreased from 38.9 mm to 28.6 mm (95% CI -16.3 to -4.2 mm). The ASES score (max 100) improved significantly from 59.9 to 70.2 (95% CI 5.3 to 15.3). Mean one-year consumption of medical resources after the index consultation was 1.5 consultations, 0.5 radiological examinations, and 3.3 visits to physiotherapist. Mean resource-weighted direct costs were €543 /patient/year (95% Cl €351 to 735). Conclusions Shoulder disorders are often chronic and require a significant amount of resources from the health care system. The clinical outcome of the management of shoulder disorders in our study population including also individuals who have consulted previously for a shoulder problem is notably poorer than the one reported by previous studies on new episodes. However, despite the relatively modest outcome, subjective disability is low.
- Subjects
HEALTH outcome assessment; SHOULDER disorders; PRIMARY health care; SHOULDER pain; PHYSICAL therapists; THERAPEUTICS
- Publication
BMC Musculoskeletal Disorders, 2013, Vol 14, Issue 1, p1
- ISSN
1471-2474
- Publication type
Article
- DOI
10.1186/1471-2474-14-348