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Five Chronic Conditions Account for One-Third of Health Care Spending Growth

Posted on: Sunday, 24 October 2004, 02:00 CDT

Just five medical conditions accounted for almost one-third of health care spending growth from 1987 to 2000, according to a report released in August. The conditions are heart disease, trauma, pulmonary disease, mental disorders and cancer.

The data showed that costs from the 15 most expensive medical conditions made up about half of the overall growth in spending. The 10 other conditions are hypertension, diabetes, back problems, arthritis, cerebrovascular disease, skin disorders, pneumonia, infectious disease, endocrine disorders and kidney disease.

According to the study, conducted by Emory University economist Kenneth Thorpe and his colleagues, increasing numbers of people are being treated for mental disorders, cerebrovascular disease, pulmonary disease and diabetes, which has contributed greatly to rapidly growing health spending. These four conditions have each seen patient increases ranging from 42 to 60 percent between 1987 and 2000.

The rise in the number of people treated for mental disorders accounted for 59 percent of its rise in cost. In this case, the growth is attributed to increasing identification and diagnosis of the disorders and more awareness of available medications.

In other cases, environmental factors contribute to higher numbers of people treated. At least 12 percent of the increase in spending is attributed to diabetes and asthma alone, both of which have been linked to environmental factors. The growth of diabetes seems to be closely related to a rise in obesity. And the increasing prevalence and severity of asthma, the most common pulmonary disease, has been linked to smoking, dust mites and poor air quality.

For eight of the 15 most expensive conditions, the cost per treated case has grown with little change to the number of patients treated. Heart disease, for example, has seen an increase in cost despite a relatively stable number of people treated. Seventy percent of the cost increase comes from more expensive treatment, including more effective drugs and technology.

For conditions such as back problems and endocrine disorders, increased costs are attributed to both increasing numbers treated and cost per treatment.

Population growth was responsible for 19 to 35 percent of the increase in spending across the 15 costliest conditions.

The full report is available as a Web exclusive in the journal Health Affairs at www.healthaffairs.org.

Copyright Health Forum Inc. Oct 2004

Source: Hospitals & Health Networks

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