Patients with back problems represent an enormous reason for visits to the hospital, with 7.3 million ED visits and more than 2.3 million hospital inpatient stays in 2008.
Of these, nearly half of patients who visited the ED and 28% of patients who required an inpatient stay had back problems listed as a principal diagnosis. The remaining listed back problems as a secondary or co-morbid complicating condition.
That's according to a statistical brief from the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project.
"Not only do back problems result in expensive and resource intensive medical care," the report's authors wrote, "but they also result in loss of functioning, reduced quality of life and reduced productivity in the workforce."
Back problems, such as spondylosis, intervertebral disc disorders or other back pain, are the ninth most expensive condition treated in U.S. hospitals, with the aggregate cost for inpatient stays for patients with a principal diagnosis of back problems was more than $9.5 billion in 2008, the report said.
Among the 2008 report's other significant findings:
- On average, every day in 2008 there were 20,000 ED visits and 6,500 hospitalizations related to back problems.
- For patients admitted to the hospital with back problems, the average total cost for the hospital stay was $14,338, significantly higher than the $10,971 cost of a hospital stay for patient with any diagnosis of a back problem.
- Hospitalizations for back problems in general were more expensive than all other inpatient stays, $9,055.
- The rate of ED visits and inpatient stays for patients with any diagnosis of back problems increased with age, with the highest rate being for patients 85 years and older (5,592.1 ED visits and 3,626.2 hospital stays per 100,000 population). However, for patients with a principal diagnosis of back problems, the rate of ED visits was highest for patients between the ages of 18 and 44. The rate of stays for patients principally hospitalized for back problems was highest for patients 65-84 years old.
- About one in four ED visits for patients with back problems were billed as uninsured, while 115 of inpatient stays for patients with a principal diagnosis of back problem were billed as uninsured.
- Back pain as a first-listed diagnosis made up only 3.9% percent of ED patients who were admitted to the hospital. However for ED patients with any diagnosis of back problems, 17.2% were admitted to the hospital.
- While the rate of inpatient stays principally for back problems remained stable during the 16-years from 1993 to 2008, there was a two-fold increase in the rate of inpatient stays in which patients complained of any kind of back problem. "This indicates that back problems are becoming more frequent as a complicating or co-morbid condition," the report said.
- Rural area had a significantly higher rate of hospitalizations for back problems, 972 per 100,000 population, compared with 725 for patients in small metropolitan areas and 697 for large metropolitan areas.