A proposal to improve healthcare value in spine care delivery: the Primary Spine Practitioner.

Back pain is the leading cause of disability in the world, with global prevalence and burden increasing with age [ [1] GBD 2015 Disease and Injury Incidence and Prevalence Collaborators 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. Lancet. 2016; 388: 1545-1602 Abstract Full Text Full Text PDF PubMed Scopus (4546) Google Scholar ]. In the United States, the prevalence and costs of back pain treatment are high and increasing [ [2] Martin B.I. Deyo R.A. Mirza S.K. Turner J.A. Comstock B.A. Hollingsworth W. et al. Expenditures and health status among adults with back and neck problems. JAMA. 2008; 299: 656-664 Crossref PubMed Scopus (1154) Google Scholar ]. In 2010, US citizens who had low back pain lost an estimated 149 million days of work, costing businesses up to $200 billion in lost productivity [ [3] Global Burden of Disease Study 2010 (GBD 2010) Mortality Results 1970-2010. http://ghdx.healthdata.org/record/global-burden-disease-study-2010-gbd-2010-mortality-results-1970-2010Date: 2012 Google Scholar ]. In 2013, musculoskeletal conditions such as back pain were the most common Social Security Disability Insurance (SSD) program qualifying diagnoses, accounting for 30.5% of program participants that year and 40% of the growth in the SSDI enrollment since 1996 [ [4] US Social Security Administration Annual Statistical Report on the Social Security Disability Insurance Program, 2013. https://www.ssa.gov/policy/docs/statcomps/di_asr/2013/di_asr13.pdfDate: 2014 Google Scholar ]. That same year, 27.5 percent of the adult population reported low back pain in the previous 3 months [ [5] National Center for Health Statistics Health, United States, 2013: with special feature on Prescription Drugs. https://www.cdc.gov/nchs/data/hus/hus13.pdfDate: 2014 Google Scholar ]. Between 1996 and 2013, low back and neck pain were identified as the third most expensive disease category in the United States, with direct costs of treatment estimated at $87.6 billion in 2013 [ [6] Dieleman J.L. Baral R. Birger M. Bui A.L. Bulchis A. Chapin A. et al. US spending on personal health care and public health, 1996–2013. JAMA. 2016; 316: 2627-2646 Crossref PubMed Scopus (668) Google Scholar ].