Patients with spondylosis, intervertebral disk disorders, and other back issues and comorbid depression may have greater healthcare expenditures than those without the comorbidity, according to a study published in Pain Medicine.

For this cross-sectional study, the investigators examined pooled Medical Expenditure Panel Survey data for the 2010 to 2012 period. Patients age ≥18 years who had spondylosis, intervertebral disk disorders, and other back disorders and with positive healthcare expenditure were included in the study (n=6739). The dependent variables were the total and subtypes of healthcare expenditures. Data on patient demographics, functional ability, and concurrent diagnoses were used to assess the influence of these variables on healthcare expenditures as well as their impact on activities of daily living.

Approximately 20% of patients (n=1316) in the cohort had self-reported depression. Presence of depression vs absence of the comorbidity in individuals with back pain was associated with higher total healthcare expenditures ($13,153 vs $7477, respectively; P <.001), as well as higher inpatient ($3687 vs $1969, respectively; P <.001), outpatient ($4436 vs $2964, respectively; P <.001), prescription ($3583 vs $1551, respectively; P <.001), and home health agency ($470 vs $146, respectively; P <.01) costs.

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Limitations of the study include its cross-sectional design, reliance on self-reported data for depression, and the lack of assessment of back pain severity.

“The study findings can help clinicians, researchers, and healthcare policy makers to reform health care delivery systems with the intention to shift the focus from disease-specific treatment to integrated care in order to address the multidimensional aspects related to back pain,” noted the study authors.

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Bilal J, Berlinberg A, Trost J, Riaz IB, Bhattacharjee S. The influence of depression on health care expenditures among adults with spondylosis, intervertebral disc disorders, and other back problems in the United States [published online November 16, 2018]. Pain Med. doi: 10.1093/pm/pny223