Specialist Musculoskeletal Provision in Primary Care: Cost-Effectiveness

Abstract

Background

About 2500 patients consult a large general practice each year with musculoskeletal problems. Following a review of service provision, a Musculoskeletal Medicine and Physiotherapy Clinic was set up within this primary care setting.

Audit

An audit of the structure of the clinic showed that it met the main recommendations of the Clinical Standards Advisory Group on Back Pain. An audit of function showed that few investigations or referrals to hospital were made. Spinal disfunctions were the most labour intensive conditions treated. Low back pain accounted for 27% of referrals and was the leading condition treated. Three measures were used to audit outcome. Activity and pain analogue scores improved in all patients treated. Results compared favourably with treated groups in clinical trials. The clinic was rated highly by patient satisfaction questionnaires. Financial comparisons showed that similar treatment in hospital outpatients would cost nearly twice as much.