{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:59:10Z","timestamp":1777463950881,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["British Journal of Pain"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To 1) estimate the utilization and costs of physician and diagnostic imaging (DI) services for shoulder, knee, and low-back pain (LBP) conditions; and 2) examine determinants of the utilization and costs of these services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients visiting a physician for shoulder, knee, or LBP conditions (identified by the ICD-9 codes) in Alberta, Canada, in fiscal year (FY) 2022\/2023 were included. Interested outcomes included numbers and costs of physician visits and DI exams stratified by condition, physician specialty, DI modality, and patients\u2019 sex and age. Multivariate regressions were used to examine determinants of the outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In FY 2022\/2023, 10.4%, 7.0%, and 6.7% of the population saw physicians for shoulder, knee, and LBP conditions, respectively. This costs Alberta $307.04 million ($67.93 per capita), of which shoulder accounted for 41%, knee 28%, and LBP 31%. In the same FY, 17,734 computed tomography (CT), 43,939 magnetic resonance imaging (MRI), 686 ultrasound (US), and 170,936 X-ray exams related to shoulder\/knee\/LBP conditions were ordered for these patients, costing another $29.07 million, of which CT accounted for 14%, MRI 48%, US 0%, and X-ray 37%. Female, older age, comorbidity scores, and capital zone used physician services more frequently. Patients with a higher comorbidity index scores or more physician visits were more likely being referred for CT or MRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Musculoskeletal conditions are common and result in patients seeking healthcare services. Visits to family physicians, specialists, and the ordering of DI contribute to extensive utilization of health services, contributing to considerable health system costs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20494637241298246","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T04:40:32Z","timestamp":1730695232000},"page":"43-50","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Costs of physician and diagnostic imaging services for shoulder, knee, and low back pain conditions: A population-based study in Alberta, Canada"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3984-7877","authenticated-orcid":false,"given":"Nguyen Xuan","family":"Thanh","sequence":"first","affiliation":[{"name":"Strategic Clinical Networks, Alberta Health Services, Edmonton, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Breda","family":"Eubank","sequence":"additional","affiliation":[{"name":"Health and Physical Education, Mount Royal University, Calgary, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna","family":"Waye","sequence":"additional","affiliation":[{"name":"Innovation Evidence Impact, Alberta Health Services, Calgary, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Werle","sequence":"additional","affiliation":[{"name":"McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Radiology, McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A","family":"Hart","sequence":"additional","affiliation":[{"name":"McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M","family":"Sheps","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, Department of Surgery, University of Alberta, Edmonton, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoff","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology, University of Lethbridge, Lethbridge, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy","family":"Wasylak","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Calgary, Calgary, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mel","family":"Slomp","sequence":"additional","affiliation":[{"name":"Bone and Joint Health- Strategic Clinical Network, Alberta Health Services, Edmonton, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,11,4]]},"reference":[{"key":"bibr1-20494637241298246","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30925-9"},{"key":"bibr2-20494637241298246","unstructured":"Canadian Institute of Health Research. Institute of musculoskeletal health and arthritis. IMHA 2014\u20132018 strategic plan: enhancing musculoskeletal, skin and oral health. 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Analytics and performance reporting branch. In\n                      Overview of administrative health datasets\n                      . Edmonton,\n                      AB: Alberta Health\n                      . 2017, https:\/\/open.alberta.ca\/dataset\/overview-of-administrative-health-datasets. Accessed July 20, 2020."},{"key":"bibr19-20494637241298246","volume-title":"Diagnostic imaging common procedure\/examination list. April 1st, 2023","author":"Alberta Health Services","year":"2019"},{"key":"bibr20-20494637241298246","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2020.108241"},{"key":"bibr21-20494637241298246","volume-title":"Inflation calculator","author":"Bank of Canada"},{"key":"bibr22-20494637241298246","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq433"},{"key":"bibr23-20494637241298246","unstructured":"Statistics Canada. 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