Annual trend in orthopaedic visits per insured individual (at beginning of each year) at one HMO. Annual data for 2009–2011, data of 2012 extrapolated from first 10 months. There is an annual increase of 1.7% (P < 0.0001 logistic regression, SAS). For 2011, these represent 2.8% of all medical encounters in the HMO. This ratio increased to 3.0% in 2012.