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Estimates and Patterns of Direct Health Care Expenditures Among Individuals With Back Pain in the United States

Luo, Xuemei PhD*†; Pietrobon, Ricardo MD; X Sun, Shawn PhD; Liu, Gordon G. PhD; Hey, Lloyd MD, MS*†

doi: 10.1097/01.BRS.0000105527.13866.0F
Health Services Research

Study Design.  Secondary analysis of the 1998 Medical Expenditure Panel Survey.

Objective.  To estimate total health care expenditures incurred by individuals with back pain in the United States, calculate the incremental expenditures attributable to back pain among these individuals, and describe health care expenditure patterns of individuals with back pain.

Summary of Background Data.  There is a lack of updated information on health care expenditures and expenditure patterns for individuals with back pain in the United States.

Methods.  This study used data from the 1998 Medical Expenditure Panel Survey, a national survey on health care utilization and expenditures. Total health care expenditures and per-capita expenditures among individuals with back pain were calculated. Multivariate regression models were used to estimate the incremental expenditures attributable to back pain. The expenditure patterns were examined by stratifying individuals with back pain by sociodemographic characteristics and medical diagnosis, and calculating per-capita expenditures for each stratum.

Results.  In 1998, total health care expenditures incurred by individuals with back pain in the United States reached $90.7 billion and total incremental expenditures attributable to back pain among these persons were approximately $26.3 billion. On average, individuals with back pain incurred health care expenditures about 60% higher than individuals without back pain ($3,498 vs. $2,178). Among back pain individuals, at least 75% of service expenditures were attributed to those with top 25% expenditure, and per-capita expenditures were generally higher for those who were older, female, white, medically insured, or suffered from disc disorders.

Conclusions.  Health care expenditures for back pain in the United States in 1998 were substantial. The expenditures demonstrated wide variations among individuals with different clinical, demographic, and socioeconomic characteristics.

This study provides updated information about health care expenditures and expenditure patterns for individuals with back pain in the United States. Our analysis indicates that the health care expenditures incurred by individuals with back pain in the United States are substantial and vary widely across individuals with different clinical and sociodemographic characteristics.

From the *Center for Clinical Effectiveness and

†Division of Orthopedic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina; and

‡Pharmaceutical Policy & Evaluative Sciences, School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina.

Acknowledgment date: February 4, 2003.

First revision date: April 24, 2003.

Acceptance date: April 30, 2003.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence to Xuemei Luo, PhD, DUMC 3645, Duke University Medical Center, Durham, NC 27710; E-mail: luo00003@mc.duke.edu

© 2004 Lippincott Williams & Wilkins, Inc.