Low back and neck pain tops U.S. health spending

In a new study, researchers found that low back and neck pain tops U.S. health spending.

They found Americans in 2016 spent an estimated $380 billion on low back and neck pain, as well as on joint and limb pain, and other musculoskeletal disorders.

In total, $3.1 trillion—or $9,655 per person, about 17.9% of the US GDP—was spent on health care by a combination of individuals and public and private insurance.

In 1996, that percentage was 13.3% of GDP, with a total amount of $1.4 trillion, or $5,259 per person.

The research was conducted by a team at the University of Washington.

Among 154 conditions included in the study, low back and neck pain generated the highest expenditures at $134.5 billion.

When combined with all other musculoskeletal disorders, such as joint and limb pain, osteoarthritis, and rheumatoid arthritis, the total exceeds $380 billion, or 14.1% of the $2.7 trillion included in this study for 2016.

Other health conditions with substantial spending in 2016 were diabetes ($111.2 billion), ischemic heart disease ($89.3 billion), and falls ($87.4 billion).

As expected, a combination of private and public insurance paid for the majority of those expenditures:

Low back and neck pain – $76.9 billion paid by private insurance, $45.2 billion paid by public insurance, and $12.3 billion paid by individuals out-of-pocket

Other musculoskeletal disorders – $73.3 billion paid by private insurance, $46.9 billion paid by public insurance, and $9.7 billion paid by individuals out-of-pocket

Diabetes – $55.4 billion paid by public insurance; $49.1 billion paid by private insurance, and $6.7 billion paid by individuals out-of-pocket

Ischemic heart disease – $48.2 billion paid by public insurance, $37.9 billion paid by private insurance, and $3.2 billion paid by individuals out-of-pocket

Falls – $40.7 billion paid by public insurance, $34.8 billion paid by private insurance, and $11.9 billion paid by individuals out-of-pocket

The majority of public insurance spending (58.6%) in 2016 was earmarked for patients aged 65 or older.

After adjusting for changes in the population size and age, spending by public insurance increased faster than private insurance, although this is driven at least partially by expansions of Medicaid.

Other findings include:

Spending in 2016 on prescription pharmaceuticals totaled $336.0 billion, with 45.4% paid by private insurance; spending by public insurance has increased from 19.1% in 1996 to 40.6% in 2016, with an increase in 2006 associated with Medicare Part D.

Spending on dementia increased substantially, from $38.6 billion in 1996 to $79.2 billion in 2016.

Data behind the study included 5.9 billion unique insurance claims, information regarding an additional 150.4 million ambulatory care visits, dental procedures, and emergency department visits; 1.5 billion inpatient and nursing facility bed-days; and 5.9 million prescribed pharmaceuticals.

The lead author of the study is Dr. Joseph Dieleman of the Institute for Health Metrics and Evaluation (IHME).

The study is published in JAMA.

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