Background: In musculoskeletal health and care, visits, tests and treatments are often optional. There is some evidence that levels of utilization can be associated with subjective aspects of the illness, mindsets (thoughts and feelings about sensations) and stressful circumstances in particular. In a cross-sectional study of people seeking musculoskeletal specialty care, we addressed two questions: 1) Is there a difference in planned care utilization based on statistical groupings of measures of the subjective aspects of the illness? And 2) Are there any factors specifically associated with scheduling a return visit?

Methods: One hundred thirty-five patients seeking musculoskeletal specialty care completed measures of subjective patient factors including unhelpful thoughts and feelings of distress regarding symptoms, personal health agency, social health, and trust and experience with the clinician. Plans for a return visit, an injection, an imaging test, or referral to a physical therapist were documented. Cluster analysis was utilized to identify statistical groupings of scores on measures of subjective personal factors. Bivariate and logistic regression analyses evaluated factors associated with planned care utilization.

Results: We identified four statistical groupings of subjective factors through Cluster analysis: Group 1 had low trust, agency, and social health; Group 2 had low social health and high distress; Group 3 had healthy mindset and circumstances; and Group 4 had the highest social health and relatively healthy levels of the other subjective measures. Furthermore, no difference observed between statistical groups of the subjective regarding planned care utilization. Multivariable analysis revealed an association between scheduling a return visit and lower extremity clinicians (RC = 0.3; 95% CI 0.05 to 0.5; P-value, 0.02) but not with statistical groupings of measures of personal factors.

Conclusion: The finding that statistical groupings of patient personal factors were not associated with planned utilization of visits, tests, or treatments is inconsistent with other evidence linking mindsets actual utilization. A better understanding of sources of variation in planned and actual utilization is needed to help limit unwarranted variation and enhance effective use of resources.

Keywords: mental health; mindset; musculoskeletal institute; social health; statistical groupings; subjective measure; tests; treatments; utilization; visits.

© The Author(s) 2025.

背景： 在肌肉骨骼健康和护理中，访问、检查和治疗通常是可选的。有证据表明，利用水平可能与疾病主观方面（如感受的想法和感觉）、心态以及特定压力情境有关联。在一项针对寻求肌肉骨骼专科护理人员进行的横断面研究中，我们回答了两个问题：1）基于对疾病主观方面的统计分组评分，计划性护理使用是否存在差异？2）是否有任何具体因素与安排复诊相关？

方法： 一百三十五名寻求肌肉骨骼专科护理的患者完成了包括无益想法和症状引起的痛苦感觉、个人健康自主权、社会健康以及对临床医生的信任和经验等方面的主观患者因素量表。计划再次就诊、注射、影像检查或转介至物理治疗师的情况被记录下来。通过聚类分析来识别主观个人因素得分的统计分组。双变量和逻辑回归分析评估了与计划性护理使用相关的因素。

结果： 通过聚类分析，我们确定了四个主观因素的统计分组：第一组信任、自主权和社会健康水平低；第二组社会健康水平低且痛苦感受高；第三组拥有健康的思维模式和情况；第四组具有最高社会健康水平和其他主观衡量指标相对健康的水平。此外，并未在不同统计分组之间观察到计划性护理利用方面的差异。多变量分析显示，安排下一次就诊与下肢临床医生有关（RC = 0.3；95% CI 0.05 至 0.5；P值为 0.02），但不与个人因素统计分组相关。

结论： 发现患者的个人因素统计分组与计划性访问、检查或治疗利用水平无关，这与其他证据相矛盾，后者表明心态会影响实际利用率。为了限制不必要的差异并提高资源的有效使用，我们需要更好地理解计划性和实际利用之间的变化来源。

关键词： 心理健康；思维模式；肌肉骨骼研究所；社会健康；统计分组；主观衡量指标；检查；治疗；利用率；访问次数。

© The Author(s) 2025.