Introduction: While the prevalence and mortality associated with chronic diseases are well studied, the relative impact common disease states have on overall health status and quality of life is poorly understood. In a systematic literature review, we set out to determine the mean quality-adjusted life year (QALY) at which U.S. citizens live with lumbar spondylosis versus other common chronic disease states and the relative impact (annual U.S. population QALYs lost) these common diseases states have on U.S. population health.
Methods: A systematic literature review was conducted for all studies utilizing the preference-based general health state instrument (EQ-5D). Only studies examining ten common disease states were included, Table 1. Both surgical and non-surgical studies were included. Pre-intervention (baseline) health state in QALYs for each reported disease state was recorded to determine a cumulative mean baseline health state from the literature. Mean health state per disease state was multiplied by the disease prevalence rates to determine the overall annual QALY lost per disease state in the U.S.
Results: A total of 137 studies (135,106 patients) met inclusion criteria, Table 1. Lumbar spondylosis patients were found to have the lowest QALY (0.39), Table 1 & 2. The estimated total annual QALYs lost in the U.S. was greatest for lumbar spondylosis (18,391,456 QALYs), 1.34-fold greater than knee osteoarthritis, 2.6-fold greater than COPD and diabetes, and 4.34-fold greater than degenerative hip disease, Table 1.
Conclusions: Lumbar spondylosis is associated with the lowest reported QALY health state. The overall impact on QALYs lost is significantly higher for lumbar spondylosis than all disease states studied. These findings suggest that degenerative lumbar spinal disorders have a large and detrimental impact on the U.S. population’s health and quality of life. Healthcare reform initiatives should allocate appropriate resources and spending to address this high impact disease process.
Patient Care: Our systematic review highlights the detrimental impact of lumbar spondylosis on general health and quality of life of US population and signifies that appropriate resources need to be allocated to address this high impact disease process and improve the quality of life of patients.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Understand the impact of degenerative lumbar spinal disorders on US population’s health and quality of life, and 2) Appreciate that appropriate resources should be allocated to address this high impact disease process.