Economic Burden


Lead Author(s): 

Scott B. Rosenfeld, MD
Brielle Payne Plost, MD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

In 2013, total hospital charges for children and adolescents age 20 years and younger with a primary musculoskeletal-related diagnosis were $7.4 billion. Musculoskeletal trauma (41%) and deformity (37%) were the major contributors to total hospital charges, but all conditions contribute to the overall economic impact of musculoskeletal conditions in this age group. Furthermore, while musculoskeletal condition hospital charges represent 5.2% of total charges for all medical conditions for the age 20 years and younger age group, the number of discharges represent only 2% of total hospital discharges for any medical condition in this age group, indicating that musculoskeletal conditions may be more expensive to treat than many other childhood conditions. (Reference Table 7C.13 PDF CSV)


It is important to note that the overall cost of musculoskeletal conditions in the 20 years and younger population is much greater than just hospital charges. First, the $7.4 billion includes only hospitalizations with a primary, or first, diagnosis in the databases, representing less than 2% of 2013 healthcare visits with any musculoskeletal condition diagnosis. Not included in this burden are expenditures for visits to emergency departments, outpatient clinics, and physicians’ office, as well as other medical care expenditures such as physical therapy, rehabilitation, and medications.

While gender is not a factor in the distribution of hospital charges, age is a major contributor. Children in the middle years of childhood, especially ages 10 to 13 years, have a higher share of total hospital charges (16%) due to musculoskeletal conditions than any other age group. Musculoskeletal condition hospital charges are also a higher share for those age 14 to 17 years (14%) and ages 5 to 9 years (8.6%).


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