The costs of musculoskeletal disease: health needs assessment and health economics

Arthritis and musculoskeletal conditions dominate the national illness burden worldwide. This chapter presents information on the different types of societal and individual impacts of musculoskeletal conditions, and describes the appropriate way to evaluate and present these effects. There are three types of 'costs' associated with musculoskeletal conditions: direct, indirect and intangible. The direct costs of care are those associated with ambulatory and inpatient medical care; these costs may be borne by the patient or society. The indirect costs are those paid and unpaid activities, such as employment, schooling and homemaking, that result from disability associated with the health condition; these costs may be borne by employers, society or the individual patient. The intangible costs of the disease are pain, emotional impairment, health worry and other effects on the patient's quality of life. All of these components of costs may, and should be, accurately measured to get the full picture of the burden of musculoskeletal conditions.