{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:38:11Z","timestamp":1790786291830,"version":"4.1.0"},"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","award":["RS-2023-KH139918"],"award-info":[{"award-number":["RS-2023-KH139918"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Musculoskeletal surgery imposes extended recovery periods and significant financial burdens that can undermine individual and system-level health security. Patients undergoing musculoskeletal surgery often face prolonged recovery and substantial post-discharge costs, yet longitudinal evidence on their healthcare use remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study quantified two-year post-discharge utilization and identified predictors of high expenditure among Korean musculoskeletal surgery patients. A retrospective cohort was constructed from the 2019\u20132021 Korea Health Panel. Adults (n\u2009=\u2009182) hospitalized for spinal, knee, shoulder or other musculoskeletal disorders between July 2019 and June 2020 were followed for 24 months. Outcomes were total healthcare expenditure (log-transformed) and in the top 25% cost group (\u201chigh-expenditure\u201d) in the second post-discharge year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 182 adults hospitalized for musculoskeletal surgery, first-year post-discharge spending averaged US $848 but fell to US $487 in the second year. Readmission fell from 19.2% to 7.1%, and Western-medicine outpatient visits declined from 18.3\u2009\u00b1\u200925.9 to 13.6\u2009\u00b1\u200922.9 per person. By contrast, Traditional Korean Medicine (TKM) visits rose from 2.3\u2009\u00b1\u20096.5 to 3.3\u2009\u00b1\u200910.0. In multivariable models, metropolitan residence, obesity, additional chronic conditions, and heavier first-year inpatient and outpatient use independently predicted higher second-year costs. Lower household income was associated with lower spending. Index diagnoses were pivotal: spinal disorders and shoulder disorders markedly increased the odds of falling into the top-cost quartile. Among the first-year TKM, frequent chuna\/manual therapy sessions were marginally associated with higher costs, suggesting these rehabilitative modalities may serve as proxies for underlying health complexity during the stabilization phase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Spinal and shoulder disorders, metropolitan residence, obesity, multimorbidity, heavy inpatient and outpatient use during the first post-discharge year, and frequent TKM sessions, albeit marginally, jointly predicted the highest second-year expenditures. These findings highlight the value of early risk stratification and tightly coordinated Western-and-traditional care pathways that facilitate the shift from structural repair to functional restoration. From a policy perspective, these results suggest the need for integrated post-discharge care models and targeted financial support strategies to reduce avoidable costs and enhance equity in musculoskeletal rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0342252","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T18:33:40Z","timestamp":1770402820000},"page":"e0342252","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Post-discharge healthcare utilization and costs in musculoskeletal surgery patients: A cohort study in Korea"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2261-253X","authenticated-orcid":true,"given":"Boyoung","family":"Jeon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9812-0745","authenticated-orcid":true,"given":"Boyoung","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Kyung","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"pone.0342252.ref001","unstructured":"World World Health Organization. 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[Cited 2025 May 1]. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/musculoskeletal-conditions"},{"key":"pone.0342252.ref002","volume-title":"Korea Occupational Safety and Health Agency KOSHA","year":"2024"},{"key":"pone.0342252.ref003","author":"United Nations Department of Economic and Social Affairs PD","year":"2024"},{"key":"pone.0342252.ref004","first-page":"356","article-title":"Occupational musculoskeletal disorders 22: medical management of musculoskeletal disorders (1) \u2013 focusing on medical management systems and primary prevention","author":"S Kim","year":"2017","journal-title":"Industrial Health"},{"key":"pone.0342252.ref005","volume-title":"Age at diagnosis of spinal and joint diseases is decreasing, while age at surgery is increasing: Healthcare Big Data Open System","author":"Health Insurance Review and Assessment Service","year":"2022"},{"key":"pone.0342252.ref006","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1186\/1471-2474-12-157","article-title":"The economic burden of musculoskeletal disease in Korea: a cross sectional study","volume":"12","author":"I-H Oh","year":"2011","journal-title":"BMC Musculoskelet Disord"},{"issue":"13","key":"pone.0342252.ref007","doi-asserted-by":"crossref","first-page":"6804","DOI":"10.3390\/ijerph18136804","article-title":"Musculoskeletal disorders, pain medication, and in-hospital mortality among patients with COVID-19 in South Korea: a population-based cohort study","volume":"18","author":"T-K Oh","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0342252.ref008","volume-title":"Top 20 most frequent surgical diseases: Healthcare Big Data Open System","author":"Health Insurance Review and Assessment Service","year":"2024"},{"key":"pone.0342252.ref009","unstructured":"Ministry of Health and Welfare. 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