Diabetes, heart disease, back pain, hypertension, and falls – top most costly health expenses

According to the latest findings by the Institute for Health Metrics and Evaluation (IHME), American healthcare spending was primarily on diabetes, heart disease, and back pain problems. Only 20 conditions made up nearly half of the healthcare spending in the U.S. Although diabetes and heart disease commonly affect those over the age of 65, neck and back pain often affected those in working age groups.

In 2013, the total spending on diabetes, heart disease, and back pain, combined with hypertension and falls was $437 billion, which amounts to 18 percent of personal healthcare spending.

Lead author Dr. Joseph Dieleman explained, “While it is well known that the US spends more than any other nation on health care, very little is known about what diseases drive that spending. IHME is trying to fill the information gap so that decision-makers in the public and private sectors can understand the spending landscape, and plan and allocate health resources more effectively.”

Other conditions which made the top 20 list included musculoskeletal disorders, such as tendinitis, carpal tunnel syndrome, and rheumatoid arthritis; and well-care (all care unrelated to the diagnosis and treatment of illnesses or injuries like dental visits; and pregnancy and postpartum care).

Other key findings from the paper included:

• Women aged 85 and older spent the most per person in 2013, at more than $31,000 per person. More than half of this spending (58 percent) occurred in nursing facilities, while 40% was expended on cardiovascular diseases, Alzheimer’s disease, and falls.
• Men aged 85 and older spent $24,000 per person in 2013, with only 37 percent on nursing facilities, largely because women live longer and men more often have a spouse at home to provide care.
• Less than 10 percent of personal healthcare spending is on nursing care facilities, and less than five percent of spending is on emergency department care. The conditions leading to the most spending in nursing care facilities are Alzheimer’s and stroke, while the condition leading to the most spending in emergency departments is falls.
• Public health education and advocacy initiatives, such as anti-tobacco and cancer awareness campaigns, totaled an estimated $77.9 billion in 2013, less than three percent of total health spending.
• Only six percent of personal healthcare spending was on well-care. Of this, nearly a third of the spending was on pregnancy and postpartum care, which was the tenth largest category of spending.

Director of IHME Dr. Christopher Murray added, “This paper offers private insurers, physicians, health policy experts, and government leaders a comprehensive review. As the United States explores ways to deliver services more effectively and efficiently, our findings provide important metrics to influence the future, both in short- and long-term planning.”
The top costly conditions in 2013 included:

1.  Diabetes – $101.4 billion
2. Ischemic heart disease – $88.1 billion
3. Low back and neck pain – $87.6 billion
4. Hypertension – $83.9 billion
5. Injuries from falls – $76.3 billion
6. Depressive disorders – $71.1 billion
7. Oral-related problems – $66.4 billion
8. Vision and hearing problems – $59 billion
9. Skin-related problems, such as cellulitis and acne – $55.7 billion
10. Pregnancy and postpartum care – $55.6 billion