Volume and characteristics of inpatient and ambulatory medical care for neck pain in the United States: data from three national surveys.

STUDY
DESIGN: Secondary analysis of national survey data.
OBJECTIVE: To describe the volume and characteristics of outpatient visits to physician offices, hospital outpatient departments and emergency departments, and inpatient hospital utilization for neck pain in the United States. We also examined the use of pathology-based versus symptom-based diagnoses on a national scale. SUMMARY OF BACKGROUND DATA: Descriptions of the epidemiology of neck pain will assist policy makers and clinicians in understanding the impact of neck pain on society.
METHODS: Analysis of combined survey data from the 2001 and 2002 National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey, and National Hospital Discharge Survey, from the Centers for Disease Control and Prevention/National Center for Health Statistics.
RESULTS: During 2001 and 2002, an average of 10.2 million visits were made annually. At 64% of visits, a symptom-based diagnosis was used. An annual average of 179,000 hospital discharges for neck pain was recorded and 94% received a pathology-based diagnosis. Most (79%) had surgery for the neck problem.
CONCLUSIONS: Outpatient visits for neck pain are common in the United States, and the majority are given symptom-based rather than pathology-based diagnoses. An alternative diagnostic taxonomy may be needed to guide treatment, particularly for patients with vague, symptom-based diagnoses. Hospitalizations for neck pain often include surgical procedures, but 21% received no surgery.