Mental health gets top billing for US medical expenditures
- Spending on mental disorders in the U.S. was $201 billion in 2013, beating out all other medical conditions, according to a study in the latest issue of Health Affairs.
- Of that amount, more than 40% was related to spending for institutionalized care.
- Rounding out the top 10 most costly medical conditions were heart problems, trauma, cancer, pulmonary disorders, osteoarthritis, normal birth, diabetes, kidney disease and hypertension.
To arrive at the estimates, study author Charles Roehrig adjusted National Health Expenditure Accounts data on spending in a number of service categories to bring them in line with other data sources and then apportioned that across various populations: Civilian noninstitutionalized, nursing home residents, long-term psychiatric hospital patients, prisoners, and active duty military.
Heart and trauma, numbers two and three on the list, trailed mental disorders at a considerable distance, with $147 billion and $143 billion in spending, respectively. Fourth was cancer, at $122 billion, with pulmonary conditions coming in fifth at $95 billion.
While spending on mental disorders outpaced other conditions, growth in spending was only 5.6% during the study period — not even making the top 10.
The four conditions with the fastest spending growth between 1996 and 2013 were gallbladder, pancreatic or liver disease; hyperlipidemia; upper gastrointestinal tract disorders; and lupus or connective tissue disorders. Each of these had an average annual growth rate of 10%.
“Nearly all of the ten fastest-growing medical conditions in terms of spending are associated with obesity,” wrote Roehrig, director of the Center for Sustainable Health Spending in Ann Arbor, MI. “However, most of the spending growth rates are far too high to be fully explained by obesity-induced increases in disease prevalence."
"A more important factor appears to be the introduction of expensive new treatments that reach increasingly larger segments of the affected population over time, causing treated prevalence to rise much faster than the prevalence of the disease,” he stated.