Comparison of healthcare utilisation, costs and health-related quality of life across the subgroups defined by the Keele STarT MSK Tool

Abstract

Objectives: The aim of this study was to describe and compare health economic outcomes (healthcare utilisation, costs, work outcomes and health-related quality of life (EQ-5D-5L)) in patients classified into different risk subgroups by the Keele STarT MSK Tool.
Methods: Data on healthcare utilisation, costs and EQ-5D-5L were collected from a healthcare perspective within a primary care prospective observational cohort study. Patients presenting with one (or more) of the five most common musculoskeletal pain presentations were included: back, neck, shoulder, knee or multi-site pain. Participants at low, medium and high risk of persistent disabling pain were compared in relation to mean healthcare utilisation, costs, health-related quality of life and employment status. Regression analysis was used to estimate costs.
Results: Over 6 months, the mean (SD) total healthcare (NHS and private) costs associated with the low, medium and high risk subgroups were £132.92 (167.88), £279.32 (462.98) and £476.07 (716.44) respectively. Mean health-related quality of life over the 6 month period was lower and more people changed their employment status in the high risk subgroup compared to the medium and low risk subgroups.
Conclusion: This study demonstrates that subgroups of people with different risk of poor musculoskeletal pain outcomes also have different levels of healthcare utilization, healthcare costs, health-related quality of life and work outcomes. The findings show that the STarT MSK tool not only identifies those at risk of a poorer outcome, but also those who will have more healthcare visits and incur higher costs.