Affiliations: National Center on Birth Defects and Developmental
Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
Note: [] Corresponding author: Lijing Ouyang, PhD, 1600 Clifton Road,
Mail Stop E-88, Atlanta, GA 30333, USA. Tel.: +1 404 498 4299, Fax: +1 404 498
3060, E-mail: [email protected]
Abstract: Objective: To describe the most prevalent conditions and their
associated expenditures for the outpatient care of individuals with spina
bifida (SB) of varying ages. Design: From a large health insurance claims
database of people with private insurance, we examined records on outpatient
health care received during 2005–2006 for individuals with SB and a matched
comparison group. Chronic conditions from the most frequently recorded 4-digit
ICD-9-CM codes for individuals with SB were grouped into four categories:
cardiovascular disease risk factors, SB secondary conditions, pain, and other
symptoms. Results: Diseases affecting the nervous, genitourinary, and
musculoskeletal systems and miscellaneous symptoms (e.g., headache, fever)
account for about 70% of outpatient expenditures, excluding those associated
with perinatal and congenital conditions. The most common and costly conditions
by age group were diseases of the nervous system for children and adults
younger than age 30 years and diseases of the musculoskeletal system for adults
aged 30–64 years. Individuals with SB had significantly elevated risks for
essential hypertension, urinary tract infection, and constipation at young ages
and headache, sleep disturbance, and fever throughout the life span. Conclusions: The frequency of health conditions associated with SB varies
across the life span. These conditions should be a priority for further
investigations to identify risk factors, treatment and prevention strategies
for individuals with SB.
Keywords: Spina bifida, rehabilitation, medical conditions, expenditures
