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Letters
June 11, 2008

Spine-Related Expenditures and Self-reported Health Status—Reply

JAMA. 2008;299(22):2627-2628. doi:10.1001/jama.299.22.2627-b

In Reply: In response to Dr Ratliff and colleagues, in this study our emphasis was on the discordance between spine-related expenditures and self-reported health status. During the study years 1997 to 2005, costs increased; instead of improvements, we noted worsening in physical limitations, work limitations, and social limitations and no improvement in scores on the 12-Item Short Form Health Survey. The diverging trends of increasing costs and worsening function should stimulate discussion regarding efficient use of scarce health care resources.

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