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Spine-Related Expenditures and Self-reported Health Status
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To the Editor: Dr Martin and colleagues1 studied expenditures and health status in adults with back and neck problems and concluded that spine-related expenditures have increased substantially from 1997 to 2005 without evidence of improvement in self-assessed health status. The study examined national estimates of medical expenditures compiled through the Medical Expenditure Panel Survey (MEPS), in which diagnosis codes were retrospectively applied based on patient reporting. We have a number of concerns with this study.
First, the relative change in expenditures from 1997 to 2005 did not achieve statistical significance (P = .07). Patients reporting spine problems spent 72% more than those not reporting spine problems in 1997 and 73% more in 2005. The rate of medical inflation seems to be constant. However, the article emphasized the non–statistically significant relative change in expenditures.
Second, many more patients with spinal cord injuries were included in the 2005 sample (0.1% in 1997 . . . [Full Text of this Article]
John Ratliff, MD
john.ratliff@jefferson.edu
Department of Neurosurgery
Alan Hilibrand, MD;
Alexander R. Vaccaro, MD, PhD
Department of Orthopedic Spine Surgery
Thomas Jefferson University
Philadelphia, Pennsylvania
RELATED ARTICLE
Expenditures and Health Status Among Adults With Back and Neck Problems
Brook I. Martin, Richard A. Deyo, Sohail K. Mirza, Judith A. Turner, Bryan A. Comstock, William Hollingworth, and Sean D. Sullivan
JAMA. 2008;299(6):656-664.
ABSTRACT
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RELATED LETTER
Spine-Related Expenditures and Self-reported Health Status—Reply
Sohail K. Mirza, Richard A. Deyo, and Brook I. Martin
JAMA. 2008;299(22):2627-2628.
EXTRACT
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