Characteristics of non-spine musculoskeletal ambulatory care visits in the United States, 2009-2016.

INTRODUCTION Despite the enormous economic and societal impact of musculoskeletal disorders, detailed data on the patient demographics and visit characteristics of non-spine musculoskeletal ambulatory care is sparse. Such data is essential to inform policymakers on population health needs and to justify healthcare resource allocation. OBJECTIVE To determine demographic, patient, and visit characteristics of adult musculoskeletalambulatory clinic visits, with the exception for spine visits, in the United States. DESIGN Survey/Registry. SETTING National Ambulatory Medical Care Survey (NAMCS), Centers for Disease Control (CDC) 2009-16. PATIENTS The NAMCS was designed to capture information regarding the provision and use of ambulatory medical care services in the United States. Non-federally employed office-based physicians reported data for this survey from 2009-16. INTERVENTIONS None. MAIN OUTCOME MEASURE(S) Average annual estimated number (in 100 000 s), Average annual estimated rate of ambulatory care musculoskeletal visits per 100 U.S. adults. RESULTS During 2009-2016, the leading cause for musculoskeletal visits was knee symptoms (15.3 million annually from 2009-10, 14.0 million annually from 2011-12, 12.5 million annually from 2013-14, and 12.4 million annually from 2015-16). Musculoskeletal visits were most frequent in patients that were 45-64 years of age(40.4%-43.6% of visits were for patients aged 45-64 depending on body region). Orthopedic surgeons conducted more musculoskeletal visits than any other physician specialty for all body regions. Amongst body regions, MRIs were ordered most commonly for patients with shoulder (total visits in 100 000 ± SE47.00 ± 0.21; 12.5% of total visits for shoulders) and knee symptoms (61.85 ± 0.15; 11.4%of total visits for knees). Opioid and opioid analgesic combinations (9.2%-14.8% of visits) were most commonly prescribed in visits related to hip complaints. CONCLUSIONS Visits were most frequent for knee symptoms and in patients of working age groups which likely affects work productivity. Orthopedic surgeons were the most common provider specialty. Opioid medications were prescribed most commonly for patients with hip symptoms, which may highlight an area for potential intervention given the ongoing opioid crisis. This article is protected by copyright. All rights reserved.