Low back and neck pain tops healthcare spending in U.S.

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In 2016, Americans spent an estimated $380 billion on low back and neck pain, as well as joint and limb pain and other musculoskeletal disorders, according to a new study published in JAMA Open Network.

In the analysis, researchers found $3.1 trillion or $9,655 per person was spent on healthcare by a combination of individuals and public and private insurance. In 1996, $1.4 trillion or $5,259 per person was spent.

Government budgets, insurance claims, facility records, household surveys, and official U.S. records from 1996 through 2016 were collected to estimate spending for 154 health conditions. Among the 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.

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

More than 58 percent of public insurance spending 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, according to the study.

Spending in 2016 on prescription pharmaceuticals totaled $336.0 billion, with 45.4 percent paid by private insurance; spending by public insurance has increased from 19.1 percent in 1996 to 40.6 percent 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 vast costs associated with health care represent one of the most important and contentious issues facing Americans today," said Joseph Dieleman, PhD, lead author of the study from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington's School of Medicine, in a statement. "Our study provides comprehensive estimates over a 20-year period that highlight how health care and prescription drugs are paid for, what they are spent on, and how such payments have changed over time."