Aging Baby Boomers and the Rising Cost of Chronic Back Pain: Secular Trend Analysis of Longitudinal Medical Expenditures Panel Survey Data for Years 2000 to 2007

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SOURCE:   J Manipulative Physiol Ther. 2013 (Jan); 36 (1): 2–11

Monica Smith, DC, PhD, Matthew A. Davis, DC, MPH,
Miron Stano, PhD, James M. Whedon, DC, MS

Adjunct Faculty (Off-Site),
National University Health Sciences,
Lombard, IL, USA.

OBJECTIVES:   The purposes of this study were to analyze data from the longitudinal Medical Expenditures Panel Survey (MEPS) to evaluate the impact of an aging population on secular trends in back pain and chronicity and to provide estimates of treatment costs for patients who used only ambulatory services.

METHODS:   Using the MEPS 2-year longitudinal data for years 2000 to 2007, we analyzed data from all adult respondents. Of the total number of MEPS respondent records analyzed (N = 71,838), we identified 12,104 respondents with back pain and further categorized 3842 as chronic cases and 8262 as nonchronic cases.

RESULTS:   Secular trends from the MEPS data indicate that the prevalence of back pain has increased by 29%, whereas chronic back pain increased by 64%. The average age among all adults with back pain increased from 45.9 to 48.2 years; the average age among adults with chronic back pain increased from 48.5 to 52.2 years. Inflation-adjusted (to 2010 dollars) biennial expenditures on ambulatory services for chronic back pain increased by 129% over the same period, from $15.6 billion in 2000 to 2001 to $35.7 billion in 2006 to 2007.

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CONCLUSION:   The prevalence of back pain, especially chronic back pain, is increasing. To the extent that the growth in chronic back pain is caused, in part, by an aging population, the growth will likely continue or accelerate. With relatively high cost per adult with chronic back pain, total expenditures associated with back pain will correspondingly accelerate under existing treatment patterns. This carries implications for prioritizing health policy, clinical practice, and research efforts to improve care outcomes, costs, and cost-effectiveness and for health workforce planning.

Key Indexing Terms:   Back pain, Costs and cost analysis, Aging, Spine, Economics, Chronic disease

From the FULL TEXT Article:


The “Baby Boomer Generation” is a demographic bulge in the US population considered by the US Census Bureau to encompass those individuals born during the demographic birth boom between 1946 and 1964 (Figure 1). [1] A “pig in a python” metaphor aptly describes the effect of this birth cohort on society, [2] as entire social infrastructures have adapted over time, first expanding and then contracting to meet the changing needs of the boomers. For example, municipal school systems were first overbuilt and then later dismantled or repurposed, to accommodate the boomers as they passed through the educational system. With boomers now approaching retirement age, the US health care system must prepare for the coming shockwave of their increasing health care needs, which will likely include a greater and more costly burden of musculoskeletal conditions such as back pain.

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