Expenditures rising for back and neck problems, but health outcomes do not appear to be improving

Although expenses related to back and neck problems have increased substantially in the last decade, outcomes such as functional disability and work limitations do not appear to be improving, according to a study in the February 13 issue of JAMA.

Back and neck problems are among the symptoms most commonly encountered in clinical practice. In a 2002 survey of U.S. adults, 26 percent reported low back pain and 14 percent reported neck pain in the previous three months, according to background information in the article. Rates of imaging and therapy for back and neck (spine) problems have increased substantially in the last decade, but it is not clear how this has effected expenditures or health outcomes for individuals with these problems.

Brook I. Martin, M.P.H., of the University of Washington, Seattle, and colleagues conducted a study to examine changes in expenditures and health status related to spine problems. The researchers analyzed 1997 – 2005 data from the nationally representative Medical Expenditure Panel Survey (MEPS). A total of 23,045 respondents (U.S. adults older than 17 years) were sampled in 1997, including 3,139 who reported spine problems. In 2005, the sample included 22,258 respondents, including 3,187 who reported spine problems.

The researchers found that expenditures were higher in each year for those with spine problems than for those without. In 1997,the average age- and sex-adjusted medical costs for respondents with spine problems was $4,695, compared with $2,731 among those without spine problems (inflation adjusted to 2005 dollars). In 2005, the average age- and sex-adjusted medical expenditures among respondents with spine problems was $6,096, compared with $3,516 among those without spine problems. From 1997 to 2005, these trends resulted in an estimated 65 percent inflation-adjusted increase in the total national expenditure of adults with spine problems, a more rapid increase than overall health expenditures.