USE OF PRIMARY HEALTH-SERVICES IN SPARSELY POPULATED COUNTRY DISTRICTS BY PATIENTS WITH MUSCULOSKELETAL SYMPTOMS - CONSULTATIONS WITH A PHYSICIAN

Study objective-To examine the extent to which people consult health centre doctors about various musculoskeletal symptoms and to identify those groups of patients who are responsible for the main workload in primary health care caused by musculoskeletal complaints. Design-A cross sectional investigation based on case records of people who visited health centre physicians. Setting-The population of six Finnish health centre districts (93 000 inhabitants, 64 physicians' posts in primary care centres). Subjects-6526 patients (7634 visits) who consulted a physician at any of six health centres during a two week period, of which 1380 consulted for musculoskeletal symptoms. Measurements and main results-The reasons for the visits were abstracted from the case records and were analysed by cross tabulation. The rate of people visiting for musculoskeletal symptoms during a two week period was on average IS per 1000 inhabitants. It was highest in men aged 45-54 years (25/1000) and in women aged 55-64 years (26/1000); the rate fell to the average in men over 54 and women over 64 years. Patients with musculoskeletal symptoms accounted for 21% of all patients and 27% of those over 1 5 years of age. Low back pain was the most common reason for consultation in men aged 25-54 years, while for women aged 35-74 years, the most common reason was neck and shoulder pain. Conclusions-Over one quarter of adults visiting a health centre doctor do so because of musculoskeletal disorders. This fact must be considered when developing health care services and organising basic education and further in-service training for doctors.