HyperMED - Back Facts

Total cost associated with musculoskeletal conditions in the United States increased from $81 billion in 1986 to $215 billion in 1995, then up another 18% in 5 years — $254 billion in 2000

• back and muscle complaints cost the Australian health care system more than $3 billion per year (Australian Financial Review [FR] 1998)

• Australian Institute of Health and Welfare (AIHW, 1998) reveals that musculoskeletal disorders are a huge and rising burden on the Australian taxpayer. Musculoskeletal disorders account for just 20% less in health care than the costs associated with cardiovascular disease

• back problems are the most costly of all musculoskeletal disorders, representing in excess of $700 million in annual health care expenditure (FR. 1998)

• osteoarthritis expenditure exceeds $624 million per year and muscle and tendon problems account for $519 million per year (FR. 1998)

• accidental falls were the most expensive complaint, representing $806 million a year in direct costs or around one-third of all costs relating to injuries (FR. 1998)

• these figures are more than double the cost burden arising from road traffic accidents, which account for $370 million in health care expenditure each year (FR. 1998)

• the adverse effect of medical treatments including surgical and medical ‘misadventures’, adverse drug reactions and negligence, was the second most costly type of injury: in excess of $400 million per year (FR. 1998)

• homicide and violence represents just 5% of expenditure associated with injuries, costing $124 million per year, while suicide and self inflicted injury cost $72 million per year (FR. 1998)

• Australian Institute of Health and Welfare state that expenditure for back and muscle related disorders has grown more significantly than expenditure for actual or direct injury (FR. 1998)

• in excess of 80% of the human race will experience some form of back-related musculoskeletal condition during their lives (Waddell 1986)

• most spinal conditions are the result of trauma and impact injury, usually occurring many years before the onset of pain and disability. Childhood injury compounded during adolescent years is a significant contributing factor to adult back pain

• back injuries contribute to in excess of 100 million lost days of work annually

• during 1986, the annual costs of spinal and back related expenditure in the United States of America exceeded US $81 billion annually (Minneapolis Tribune 1986). During 1994/95 USA costs had doubled, exceeding $215 billion and in excess of 254 billion in 2000

• the incidence of back surgery in the United States America is reported to peak at age 40 years

• peak incidence of back surgery of injured Victorian workers is between age 35-49 years (Victorian Workcover Authority 1995-1996)

• back surgery and the cost of ongoing treatment continues to drive the Public Health and the third party insurance bottom lines upwards. Government policies have significantly reduced patient care availability attempting to foster the mind-set that back problems are short term, self resolving, require little diagnostic investigation with preventative long term strategies replaced with short term, ‘quick fix’ palliative care

One of every four Americans have a Musculoskeletal condition

Recent publication by Bone and Joint Decade Web site at www.boneandjointdecade.org posted June 13, 2000 on MedscapeWire, indicate the alarming rise of both direct and indirect costs associated with musculoskeletal related problems. These figures do not identify the significantly higher socio-economic impact of neurodegenerative disorders and chronic infectious related conditions, which are experiencing an alarming rise annually.

Medscape reports that musculoskeletal injuries and disorders in the USA population have reached epidemic proportions, costing US $254 billion annually, and affecting 25% of all people, according to a report released at the launch of the Bone and Joint Decade. The United Nations, the World Health Organization, and 22 countries have proclaimed the years 2000-2010 as the Bone and Joint Decade. Medscape reports USA President Clinton support for this global initiative to raise awareness of musculoskeletal health, stimulate research, and improve quality of life for people with these conditions. This is significant given the fact that funding for continued medical research in this area has diminished over recent years.

• 'Total costs of musculoskeletal conditions in America increased 18% in 5 years — from $215 billion in 1995 to $254 billion in 2000,'

reported Dorothy Rice, ScD, former director of the National Centre for Health Statistics and currently professor emeritus of health economics at the University of California in San Francisco. 'This is an exciting challenge, worthy of a new century,' said Rice, noting that worldwide, musculoskeletal conditions are the most common cause of physical disability and severe long-term pain.

Orthopaedic surgeon Stuart L. Weinstein, MD, chairman of the Bone and Joint Decade Task Force, and based in Iowa City, Iowa, said, 'If we make a global commitment to research, education, and prevention strategies, we can reduce the prevalence of musculoskeletal conditions.'

Speaking to the patient advocacy groups, medical and health organizations, and government agencies gathered for the Bone and Joint Decade ceremonies, Dr. Weinstein said that musculoskeletal conditions restrict the ability of more than 36 million Americans to perform activities of daily living.

'We must take care of the aging population and maximize their quality of life,' he said. 'Over the next 30 years, baby boomers too potentially face falls, hip fracture, osteoporosis, arthritis, ligament repair, among other challenges. We also have key opportunities to enhance the well-being of children and young adults.'

Citing data analysed by the American Academy of Orthopaedic Surgeons, Dr. Weinstein noted that each year in the United States:

• musculoskeletal injuries are responsible for employees' 147 million work-loss days

• musculoskeletal injuries are responsible children's 21 million school-loss days.

• more than 28.6 million people sustain a musculoskeletal injury, which is more than half of all reported injuries.

• musculoskeletal impairment keeps individuals bedridden a total of 153 million days.

• musculoskeletal impairment is the number one reason why people go to the doctor.

'Major research break-through during the Bone and Joint Decade will improve people's mobility and healing,' said Dr. Weinstein.

Dorothy Rice noted that $1 of every $10 spent for healthcare in the United States is spent for treatment and care of persons with musculoskeletal conditions.

• 'The US $254 billion cost of musculoskeletal conditions includes direct medical and non-health costs such as transportation to providers, as well as indirect costs, such as the value of lost productivity due to illness, disability, and premature death due to these conditions,' she said. 'Unless we act now, joint disease, spinal disorders, severe trauma, and an aging population will fuel increased prevalence of musculoskeletal conditions.'