Medical Care Expenditures for Select Musculoskeletal Diseases

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Lead Author(s): 

Edward H. Yelin, PhD
Miriam Cisternas, MA

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

The following section looks at specific musculoskeletal disease conditions to provide broad estimates of costs associated with them. However, it should be noted that medical conditions in MEPS are self-reported, and may result in misreporting, and, thus, misrepresentation, of some conditions. An additional issue is that estimates for the prevalence and impact of specific conditions may differ year to year due to small sample sizes and the inherent variability that results. To improve the reliability for specific conditions, including gout, osteoarthritis and related disorders, rheumatoid arthritis, and other and unspecified disorders of the back, estimates are based on a merging of MEPS data from the most recent seven years, 2008-2014. In this edition, we also make estimates of direct costs associated with connective tissue disease, the most common of which is systemic lupus erythematosus.

As noted previously, the average all-cause expenditures for persons with all forms of musculoskeletal disease averaged $8,206 in 2012-2014. (Reference Table 8.4.1 PDF CSV)

Arthritis and Spine Conditions

Over the period, 2008-2014, slightly more than 3 million persons self-reported gout, about 32.5 million reported osteoarthritis and related disorders, 1.7 million reported rheumatoid arthritis, and 19.4 million reported other and unspecified disorders of the back.  All-cause medical care expenditures averaged $11,936 for persons with gout, $11,502 for those with osteoarthritis and related disorders, $19,040 for those with rheumatoid arthritis, and $8,622 for those with back disorders. Thus, for all conditions other than back disorders, all-cause expenditures were much larger than the average among all persons with musculoskeletal disorders. (Reference Table 8.13 PDF CSV)

Connective Tissue Disorders

Over the period 2008-2014, about 800,000 persons self-reported connective tissue disorders.  Persons with connective tissue disorders averaged $19,702 in all-cause expenditures, similar to the average among those with rheumatoid arthritis.  The magnitude of the all-cause expenditures would appear to be affected by insurance status and region of the country.  For the former, those with public insurance had higher average expenditures, $29,579, than those with private insurance, $16,003, probably reflecting the older age and greater severity of disease among the former.  Those with no insurance had all-cause expenditures of only $5,631, indicating that their care may be systematically different in scope.  Such expenditures were much higher for those in the Northeast ($27,349) or West ($26,210) than in the Midwest ($11,821) or South ($14,741). Expenditures for ambulatory care accounted for 40% of the total in the Northeast region, while inpatient care accounted for 45% in the West region. Prescription costs were highest in the Midwest, accounting for 44% of total. These numbers indicate differences in care strategies for connective tissue disorders across the country. Age and education may also be factors in care strategies, with older and the highest educated persons using ambulatory care more, while younger persons and those with less than a college degree use inpatient care more. (Reference Table 8.19 PDF CSV; Table 8.20 PDF CSV; Table 8.21 PDF CSV)


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