Background/Purpose: Back pain is a very prevalent complaint affecting two-thirds of population, and accounts for 90.7 billion dollars annually in healthcare expenditure. The occurrence of depression is reported in existing literature among patients with back pain, but there is limited information regarding healthcare expenditures among patients with back pain and concurrent depression. To assess excess total and subtypes of healthcare expenditures among adults with spondylosis, intervertebral disc disorders and other back problems who reported having depression compared to those without depression in the United States (US).

Methods: We utilized a cross-sectional design pooling MEPS data from 2010-2012. The eligible study sample comprised of adults (age ≥ 18 years), who were alive during the calendar year and reported positive healthcare expenditure. Total and subtypes of healthcare expenditures constituted the dependent variable. Ordinary least square (OLS) regressions on logged expenditures were performed. Three models were developed to assess the influence of demographics, functional ability, and concurrent diagnoses on healthcare expenditures. All expenditure data are presented in terms of 2012 US dollars.

Results: A total of 6,559 adults with spondylosis, intervertebral disc disorders, and other back problems were assessed, 20.2% of which had concurrent depression. Adults with concurrent depression had significantly higher healthcare expenditures ($13,153) compared to the non-depression group ($7,477), p<0.001. Inpatient, outpatient, prescription, and home health agency expenditures showed similar findings. There was no difference in emergency room and other expenditures between the two groups. The excess total expenditure was higher (119%) among depression group when adjusted for demographic characteristics. After adjusting for healthcare and functional disabilities, and comorbidities excess cost remained higher in depression group (53%).

Conclusion: This study demonstrates that presence of depression in the adults with spondylosis, intervertebral disc disorders, and other back problems significantly influence the economic burden. These findings remained consistent despite adjusting for all independent level variables (demographic characteristics, functional status, comorbidities). The study findings suggest that interventions resulting in better control of depression have the potential to significantly reduce the economic burden in this population.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/influence-of-depression-on-healthcare-expenditures-among-adults-with-spondylosis-intervertebral-disc-disorders-and-other-back-problems-in-the-united-states/