• Reumatología clinica · Jul 2017

    Evaluation of the implementation of an integrated program for musculoskeletal system care.

    • Igor Larrañaga, Myriam Soto-Gordoa, Arantzazu Arrospide, María Luz Jauregi, Jesús Millas, Ricardo San Vicente, Jabier Aguirrebeña, and Javier Mar.
    • Unidad de Investigación AP-OSI, OSI Alto Deba, Arrasate-Mondragón, España. Electronic address: igor.larranagauribetxebarria@osakidetza.net.
    • Reumatol Clin. 2017 Jul 1; 13 (4): 189-196.

    IntroductionThe chronic nature of musculoskeletal diseases requires an integrated care which involves the Primary Care and the specialities of Rheumatology, Traumatology and Rehabilitation. The aim of this study was to assess the implementation of an integrated organizational model in osteoporosis, low back pain, shoulder disease and knee disease using Deming's continuous improvement process and considering referrals and resource consumption.Material And MethodsA simulation model was used in the planning to predict the evolution of musculoskeletal diseases resource consumption and to carry out a Budget Impact Analysis from 2012 to 2020 in the Goierri-Alto Urola region. In the checking stage the status of the process in 2014 was evaluated using statistical analysis to check the degree of achievement of the objectives for each speciality.ResultsSimulation models showed that population with musculoskeletal disease in Goierri-Alto Urola will increase a 4.4% by 2020. Because of that, the expenses for a conventional healthcare system will have increased a 5.9%. However, if the intervention reaches its objectives the budget would decrease an 8.5%. The statistical analysis evidenced a decline in referrals to Traumatology service and a reduction of successive consultations in all specialities.DiscussionThe implementation of the integrated organizational model in osteoporosis, low back pain, shoulder disease and knee disease is still at an early stage. However, the empowerment of Primary Care improved patient referrals and reduced the costs.Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

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