title: Estimates and patterns of direct health care expenditures among individuals with back pain in the United States.
abstract: METHODS
  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.
  
  
  BACKGROUND
  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 dollars and total incremental expenditures attributable to back pain among these persons were approximately 26.3 billion dollars. On average, individuals with back pain incurred health care expenditures about 60% higher than individuals without back pain (3,498 dollars vs. 2,178 dollars). 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.
authors.affiliation: Center for Clinical Effectiveness, Division of Orthopedic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA. luo00003@mc.duke.edu
authors.forename: Xuemei
authors.initials: X
authors.lastname: Luo
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pietrobon
authors.forename: Shawn X
authors.initials: SX
authors.lastname: Sun
authors.forename: Gordon G
authors.initials: GG
authors.lastname: Liu
authors.forename: Lloyd
authors.initials: L
authors.lastname: Hey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D003365:Costs and Cost Analysis; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States