Third Edition Data to address goals of the Global Alliance for Musculoskeletal Health History 20022011 declared United States Bone and Joint Decade 2007 BMUS1 published print 2011 BMUS2 published web ID: 716152
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Burden of Musculoskeletal Diseases,
Third EditionData to address goals of the Global Alliance for Musculoskeletal Health
History2002-2011 declared United States Bone and Joint Decade2007 BMUS1 published (print)2011 BMUS2 published (web)2012 United States Bone and Joint Initiative formed2014 BMUS3 launched @ www.boneandjointburden.org
GoalsImprove quality of life for people with musculoskeletal conditionsAdvance understanding and treatment through research, prevention, and educationSupport for increased research funding
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal Health
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The Big Picture
Impact of Musculoskeletal Diseases on
Individuals
The Health Care System
The US Economy
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide4
Low Back and Neck Pain
Spinal Deformity
Arthritis and Related ConditionsOsteoporosis and Bone HealthInjuries – Traumatic, Workplace, Sports, MilitaryChildren and Adolescents
Tumors of Bones and Joints, Muscles and TissuesRare Bone DiseasesNeuromuscular DisordersDiseases of the Muscles
AgingSex and Gender
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United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide5
Prevalence
of Musculoskeletal Diseases
1 in 2
(126.6 million) adults are affected, twice the rate of chronic heart and lung conditions
Source: National Center for Health Statistics, National Health Interview Survey, 2012
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United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide6
[1] Includes hospital
discharges, ED
, outpatient, and physician visits.
[2] Includes only hospital discharges and ED visits.
Source: National Center for Health Statistics, NHDS, NAMCS, 2010.
51.8
million
adults report they have arthritis
75.7 million adults suffer from neck or low back pain 4.5 million sports musculoskeletal injuries require medical attention each year,
64
% of all sports injuries
1
in 2 women and 1 in 4 men
over age 50 will have an osteoporosis-related fracture, with
20%
mortality rate within 12 months of a hip fracture
Millions more
suffer from spinal deformities, congenital conditions, cancers of bone and connective tissue, and rare musculoskeletal diseases
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United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide7
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Disproportionately affect older persons, accounting for >50% of all chronic conditions in people older than 50 years
Age 65 and older population to nearly double in next 25 yearsIn 2040, persons age 65 and older will constitute 21% of US population, equal to the share who are 18 and under.United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide8
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Health Care Visits
for Musculoskeletal Diseases
File: G1E.0.1.png
18%
of all health care visits in 2010/2011 had a musculoskeletal condition diagnosis listed
29%
of hospital discharges
16%
of
physician visits
14%
of
outpatient visits
29%
of
emergency department visits
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide9
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Chronic Pain
of Musculoskeletal Diseases1 in 4 persons over age of 18 report chronic joint pain in at least one joint
Knee is the most frequent site (17%)Shoulder
is 2nd most frequent site
(8%)
Hip
is 3rd most frequent site (6%)40% = percentage of persons over age 65 with chronic joint pain
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide10
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Limitations
due to Musculoskeletal Diseases6% of population reports limitations carrying out common activities of daily living (eating, dressing, bathing) due to musculoskeletal diseases14% ages 65-75 report limitations due to musculoskeletal condition
23% age 75 and olderTwice the rate of circulatory (heart conditions), the second highest cause of limitations
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide11
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Limitations
due to Specific MSK Diseases5%-6% of population over age 18 report limitations carrying out common activities of daily living are due to back or neck problems14%
age 75 and older have limitations due to arthritis For all musculoskeletal diseases, the rate of limitations increases sharply as population ages
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide12
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Limitations
due to All DiseasesRate of persons in the work force unable to work or limited in type of work due to musculoskeletal diseases is twice that of any other medical condition.
28 in 1000 persons in work force unable to work due to musculoskeletal condition17 in 1000 limited
in type of work they can do.
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide13
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Bed Days
due to Musculoskeletal DiseasesA bed day is ½ or more days in bed due to injury or illness in a 12 month period, excluding hospitalization1 in 3 persons age 18 and over report at least one bed day for medical reasons
72% of them had a bed day due to musculoskeletal condition – 1 in 4 adults
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide14
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Lost Work Days
from Musculoskeletal DiseasesA lost work day is absence from work due to illness or injury in 12 month period, excluding maternity or family leave1 in 6 persons age 18 and over report at least one lost work day for medical reasons
74% of them cite a lost work day due to a musculoskeletal condition – 1 in 8 persons in the work force
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide15
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Burden
of Musculoskeletal DiseasesWidespread prevalence Three of the most costly healthcare conditions
TraumaBack painArthritis
Low mortality from musculoskeletal diseases, but high
morbidity
Restrict activities of daily living
Cause lost work days
Source of lifelong painUnited States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide16
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Definitions of Cost
Direct Costs = Health care costs for treatment of disease.Indirect Costs = Impact of disease in terms of lost wages due to disability or death.Aggregate Total Costs = Total medical costs for musculoskeletal diseases and other comorbid conditions of persons with musculoskeletal conditions.Incremental Costs
= Share of costs directly attributable to musculoskeletal disease.
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide17
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$796
Billion = Aggregate total costs, annually for years 2009 to 2011$213 Billion = Incremental costs, annually for years 2009 to 2011Direct Cost
of Musculoskeletal Diseases
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide18
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$77.5
Billion = Total indirect costs, annually for years 2009 to 2011$131 Billion = Incremental costs, annually for years 2009 to 2011**Indirect costs attributable to musculoskeletal disease are greater than totalindirect costs because of a 4% gap in the probability of working between persons with and without a musculoskeletalcondition and a lower mean income.
Indirect Cost of Musculoskeletal Diseases
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide19
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$873.8 Billion = 5.7%
GDP 2009-2011 (average)
in 2011 $s = $15,244.7 billion
File: G10E.2.1
Share of US Gross Domestic Product
5.7%
=
Aggregate Total
share of US GDP, annually for
years 2009 to
2011
3.4%
=
Aggregate Total
share
of US GDP, annually for years
1996
to
1998
68% increase
in share of GDP over 15 year period
2009-2011 Breakdown
Aggregate Total
Incremental
Direct Costs
5.22%
1.40%
Indirect Costs
0.51%
0.86%
Total All Costs
5.73%
2.25%
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide20
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Future Cost
of Musculoskeletal DiseasesBaby Boomer Generation Since 1997-1999, the burden of cost to treat musculoskeletal diseases is shifting to the aging Boomer generation
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide21
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Research Funding
to NIAMS*
File: G1A.0.1
Source: National Institutes of Health. Estimates of Funding for Various Research, Condition, and Disease Categories.
http://report/nih.gov/categorical_spending.aspx
Accessed December 17, 2013.
$7.8 billion
=
Total
research funding for years 2009
to
2013.
Less than 2% of annual National Institutes of Health (NIH) research budget allocated to NIAMS
Annual average share of funding declining since 2000
In
spite of prevalence and high morbidity, musculoskeletal diseases research dollars a fraction of
allocations for
other common
conditions
*National
Institute of Arthritis and Musculoskeletal and Skin Diseases
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide22
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Research Funding
by Type of MSK Disease50% to trauma/injuries26%
to arthritis/AORC12% to osteoporosis
11% to all other and rare musculoskeletal diseases
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal HealthSlide23
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Key Challenges to Future
Medical costs rapidly increasing for persons age 45 to 64.Total medical costs rose 40% between 1996-1998 and 2009-2011.Incremental costs attributed to musculoskeletal diseases rose 67% between
1996-1999 and 2009-2011.Persistence of chronic musculoskeletal diseases that begin in middle years 45 to 64 throughout lifetime.
Aging
population.
Lack of research funding for treatment and prevention of painful and debilitating musculoskeletal diseases.
United States Bone and Joint Initiative, the U.S. National Action Network of the Global Alliance for Musculoskeletal Health