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Healthcare spending in the US amounted to $1.4 trillion in 2013, or more than one-sixth of the entire US economy, according to a report published in the Journal of the American Medical Association (JAMA). The analysis – which examined 183 data sources to estimate spending on 155 conditions – reveals that the top 20 accounted for an estimated 57.6% of all personal healthcare spend.

[Editor’s note: While all figures cited in this article refer to spending in 2013, the amounts are reported in 2015 US dollars.]

Of the 155 conditions analyzed, more was spent on diabetes (an estimated $101.4 billion) in 2013 than on any other, per the study. Moreover, diabetes was one of the fastest-growing conditions during the 1996-2013 period, with personal healthcare spending on the condition increasing by an estimated 6.1% per year. That was the 4th-fastest rate of increases of the top 20 conditions, behind only low back and neck pain (#4; 6.5% annualized growth); treatment of hyperlipidemia (#13; 10.3% annual increase); and the aggregate of “other” neurological disorders (#18; 7.3% annual increase) that exclude Alzheimer/dementias, migraines, tension headaches, Parkinsons, MS, and Epilepsy.

The top 5 conditions by personal healthcare spend were each much more heavily weighted to spending by adults aged 65 and over than to youth under the age of 20. Specifically, they broke out as follows:

  • 1. Diabetes mellitus: $101.4 billion (1.7% share under 20 years; 42.8% for 65 and up);
  • 2. Ischemic heart disease: $88.1 billion (0.2% under 20; 61.2% for 65 and up);
  • 3. Low back and neck pain: $87.6 billion (2.0% under 20; 28.8% for 65 and up);
  • 4. Treatment of hypertension: $83.9 billion (0.7% under 20; 53.4% for 65 and up); and
  • 5. Falls: $76.3 billion (10.3% under 20; 48.2% for 65 and up).

Overall, close to 38% of healthcare spending in 2013 was for adults aged 65 and older, while 11.1% of total personal healthcare spending was for people under 20 years of age. Of the top 20 conditions, 4 had above-average share of spending on people under 20:

  • Oral disorders (#7), where they accounted for 13.1% of spending;
  • Skin and subcutaneous diseases (#9), where they represented 14.4% of spending;
  • Well dental (#14; general exams and cleaning, x-rays, orthodontia), where they were 37.4% of spending; and
  • Lower respiratory tract infection (#20), where they accounted for 16.6% of spending.

When aggregating the 155 conditions into 14 overarching categories, the analysis found that cardiovascular diseases represented the most spending, at $231.1 billion. Diabetes, urogenital, blood and endocrine diseases were next, at a combined $224.5 billion.

The full study can be accessed here.

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