TRENDS IN BACK PAIN HEALTHCARE UTILIZATION AND EXPENDITURES AMONG U.S. ADULTS: 2007 VS 2023
Author(s)
Cynthia Chapman, DC, MPH1, Rho Henry Olaisen, PhD, MPH2, Krista Ward, DC, MPH3;
1Northeast College of Health Sciences, Seneca Falls, NY, USA, 2Uniformed Services University Health Sciences, Bethesda, MD, USA, 3Life Chiropractic College West, Hayward, CA, USA
1Northeast College of Health Sciences, Seneca Falls, NY, USA, 2Uniformed Services University Health Sciences, Bethesda, MD, USA, 3Life Chiropractic College West, Hayward, CA, USA
OBJECTIVES: Back pain is a leading cause of disability worldwide. A previous analysis using 2007 Medical Expenditure Survey (MEPS) data found approximately 19 million United States (U.S.) adults were treated for back conditions with $1,589 average per person expenditure on back-related care. This current study compared 2007 treated prevalence of adult back problems and total, ambulatory, and prescribed medical back problem expenditures across insurance groups to 2023 data.
METHODS: We used MEPS data that is representative of the civilian noninstitutionalized U.S. population. Adults (aged ≥ 18) were classified with back problems if they had an International Classification of Diseases code documented in MEPS for a back condition, consistent with prior Agency for Healthcare Research Quality methodology. We compared population proportions between 2007 and 2023 time periods using z-tests and evaluated differences in payer distributions across care settings using chi-square tests (2007 data adjusted for inflation).
RESULTS: The percentage of the U.S. adults population treated for back problems remained stable between the years 2007 and 2023 (8.4% 2007 [95% CI 7.9, 8.9) and 9% 2023 [95% CI 8.5, 9.5]). Back problem expenditures increased from $40.8B in 2007 (3% of total health care expenditures) to $103B in 2023 (4.5% of total expenditures) and mean per-person expenditures rose from $2158 to $4300. Mean ambulatory back problem expenses increased ($1637 to $2598) while medication expenses decreased ($629 to $206). Private insurance remained the payer for the largest share of back problem expenditures in most care settings while Medicare remained the primary payer for prescription medications.
CONCLUSIONS: Back problems remain highly prevalent and impose an increasing economic burden on the U.S. healthcare system. Higher pharmaceutical utilization among Medicare beneficiaries suggests potential gaps in guideline-concordant care. Further research is needed to identify strategies to optimize evidence-based care delivery across payer groups.
METHODS: We used MEPS data that is representative of the civilian noninstitutionalized U.S. population. Adults (aged ≥ 18) were classified with back problems if they had an International Classification of Diseases code documented in MEPS for a back condition, consistent with prior Agency for Healthcare Research Quality methodology. We compared population proportions between 2007 and 2023 time periods using z-tests and evaluated differences in payer distributions across care settings using chi-square tests (2007 data adjusted for inflation).
RESULTS: The percentage of the U.S. adults population treated for back problems remained stable between the years 2007 and 2023 (8.4% 2007 [95% CI 7.9, 8.9) and 9% 2023 [95% CI 8.5, 9.5]). Back problem expenditures increased from $40.8B in 2007 (3% of total health care expenditures) to $103B in 2023 (4.5% of total expenditures) and mean per-person expenditures rose from $2158 to $4300. Mean ambulatory back problem expenses increased ($1637 to $2598) while medication expenses decreased ($629 to $206). Private insurance remained the payer for the largest share of back problem expenditures in most care settings while Medicare remained the primary payer for prescription medications.
CONCLUSIONS: Back problems remain highly prevalent and impose an increasing economic burden on the U.S. healthcare system. Higher pharmaceutical utilization among Medicare beneficiaries suggests potential gaps in guideline-concordant care. Further research is needed to identify strategies to optimize evidence-based care delivery across payer groups.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE450
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)