{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T07:44:37Z","timestamp":1787903077139,"version":"build-2784847793"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T00:00:00Z","timestamp":1542326400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Back pain is a very prevalent complaint, affecting two-thirds of the US population, and it accounts for $100 billion annually in health care expenditures. The occurrence of depression has been reported in existing literature among patients with back pain, but there is limited information regarding health care expenditures among patients with back pain and concurrent depression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess excess total and subtypes of health care expenditures among adults with spondylosis, intervertebral disc disorders, and other back problems who reported having depression compared with those without depression in the United States.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We utilized a cross-sectional design, pooling Medical Expenditure Panel Survey data from 2010\u20132012. The eligible study sample included adults (age \u226518\u2009years) who reported positive health care expenditure. Total and subtypes of health care expenditures constituted the dependent variable. Ordinary least squares (OLS) regressions on logged expenditures were performed. Four models were developed to assess influence of demographics, functional ability, and concurrent diagnoses on health care expenditures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 6,739 adults with spondylosis, intervertebral disc disorders, and other back problems were assessed, 20.2% (N\u2009=\u20091,316) of whom had concurrent depression. Adults with concurrent depression had significantly higher total health care expenditures ($13,153) compared with the nondepression group ($7,477, P\u2009&amp;lt;\u20090.001). Outpatient and prescription expenditures showed similar findings. After adjusting for demographics, functional disabilities, and comorbidities, excess cost remained higher in the group reporting concurrent depression (46%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study demonstrates that the presence of depression in adults with spondylosis, intervertebral disc disorders, and other back problems is associated with greater economic burden. These findings remained consistent after adjusting for all independent sets of variables. The study\u2019s findings suggest that interventions resulting in better management of depression have the potential to significantly reduce the economic burden in this population.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pny223","type":"journal-article","created":{"date-parts":[[2018,10,29]],"date-time":"2018-10-29T02:41:57Z","timestamp":1540780917000},"page":"e45-e53","source":"Crossref","is-referenced-by-count":4,"title":["The Influence of Depression on Health Care Expenditures Among Adults with Spondylosis, Intervertebral Disc Disorders, and Other Back Problems in the United States"],"prefix":"10.1093","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7015-8151","authenticated-orcid":false,"given":"Jawad","family":"Bilal","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Arizona , Tucson, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Berlinberg","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Arizona , Tucson, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaren","family":"Trost","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Arizona , Tucson, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irbaz Bin","family":"Riaz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mayo Clinic , Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandipan","family":"Bhattacharjee","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science, College of Pharmacy , University of Arizona, Tucson, Arizona,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,11,16]]},"reference":[{"issue":"1","key":"2025082212314744400_pny223-B1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.jmpt.2012.12.001","article-title":"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","volume":"36","author":"Smith","year":"2013","journal-title":"J Manipulative Physiol Ther"},{"issue":"10053","key":"2025082212314744400_pny223-B2","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1016\/S0140-6736(16)31678-6","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015","volume":"388","author":"Vos","year":"2016","journal-title":"Lancet"},{"issue":"8","key":"2025082212314744400_pny223-B3","first-page":"1181","article-title":"Evaluation and treatment of acute low back pain","volume":"75","author":"Kinkade","year":"2007","journal-title":"Am Fam Physician"},{"issue":"3","key":"2025082212314744400_pny223-B4","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1001\/archinternmed.2008.543","article-title":"The rising prevalence of chronic low back pain","volume":"169","author":"Freburger","year":"2009","journal-title":"Arch Intern Med"},{"key":"2025082212314744400_pny223-B5","first-page":"93","volume-title":"The Adult Spine: Principles and Practice","author":"Anderssen","year":"1997"},{"key":"2025082212314744400_pny223-B6","first-page":"1","article-title":"Surgical operations in short-stay hospitals: United States, 1978","volume":"61","author":"Pokras","year":"1982","journal-title":"Vital Health Stat 13"},{"key":"2025082212314744400_pny223-B7","first-page":"1","article-title":"Inpatient utilization of short-stay hospitals by diagnosis; 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