Background/Purpose: Medical care costs have been a major concern for public policy for a generation. Concern about costs of musculoskeletal conditions (MUSC) has been fueled by the aging of the population which puts a growing fraction of the population at risk for these conditions. We document the growth in medical care costs of MUSC from 1996-2011 and analyze the role that aging of the population, age-specific prevalence of the conditions, increased medical care utilization, and increased prices for services play in this growth.

Methods: We analyzed the 1996-1998 and 2009-2011 Medical Expenditure Panel Survey (MEPS).Using three-year periods provides more stable estimates of long-term trends. In MEPS, persons self-report conditions causing utilization, disability, or symptoms. Responses are coded to ICD-9-CM 3-digit codes; musculoskeletal codes included arthritis and joint pain, spine conditions, osteoporosis, musculoskeletal injuries, and other musculoskeletal conditions. We calculated per person and aggregate costs in constant 2011 dollars, by type (ambulatory, hospital, prescription medications, and “other” which includes devices, ED visits, personal assistance, and other services).

Results: Between 1996-1998 and 2009-2011 prevalence of musculoskeletal conditions rose by 35%, from 76.0 to 102.5 million while costs rose 117%, from $367.2 to $796.2 billion (Table 1). The increased costs resulted from larger populations aged 45-64 and ≥ 65, increased prevalence of MUSC in these age groups, higher unit prices for ambulatory care, hospital admissions, and prescriptions as well as increased numbers of prescriptions used (Table 2). Hospital admissions and ambulatory care utilization did not increase appreciably during this time.

Conclusion: The aging of the baby boom generation will lead to short term increases in the population at greatest risk for MUSC. Reducing costs of these conditions will require public health approaches to reduce the prevalence of MUSC through such mechanisms as weight control and exercise programs as well as change in the organization of health care to attenuate the increases in the unit prices of services, especially of prescription medications.