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Research Findings #19: Health Care Expenses for Injuries: Estimates from the 1997 MEPS

by Nancy A. Krauss, M.S., Steven R. Machlin, M.S., Agency for Healthcare Research and Quality; Gregory A. Adams, M.A., Doctoral Candidate, University of Massachusetts



Abstract

This report from the Agency for Healthcare Research and Quality uses data from the 1997 Medical Expenditure Panel Survey (MEPS) Household Component to examine the health care costs of injury-related conditions. An estimated $57.9 billion was spent on injury-related conditions for the U.S. civilian noninstitutionalized population. Approximately 62 million people were reported to have had an injury-related condition. Seventy percent of the people with an injury-related condition (43 million people) had a medical expense related to that condition. This report gives estimates of injury-related expenses for inpatient hospital services and ambulatory medical care services by age, sex, race, health insurance, and poverty level. Injury-related expenses as a proportion of total medical expenses, and mean and median expenses are also discussed. The proportion of expenses for injury and noninjury medical care paid by various sources, including out-of-pocket, Medicare, Medicaid, private insurance, and Workers’ Compensation, are also compared.

The estimates in this report are based on the most recent data available at the time the report was written. However, selected elements of MEPS data may be revised on the basis of additional analyses, which could result in slightly different estimates from those shown here. Please check the MEPS Web site for the most current file releases.

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Introduction

Injuries are the fifth leading cause of death in the United States (Hoyert, Arias, Smith, et al., 2001) and the leading cause of death for people ages 1-44 (Department of Health and Human Services (U.S.), 2000). The risk of injury is so great that most people sustain a significant injury at some time during their lives (Department of Health and Human Services (U.S.), 2000). It is not surprising that injuries impose a large burden on national health care costs, exceeded only by heart disease and cancer (Cohen and Krauss, 2003).

This report presents estimates from the 1997 Medical Expenditure Panel Survey Household Component (MEPS HC) of spending for direct medical care provided for conditions caused by injuries among the U.S. civilian noninstitutionalized population. Because direct medical costs do not include reduced or lost productivity in the working-age population or the nonmonetary cost of the disability and emotional stress caused by injuries, this report does not analyze the total economic burden attributable to injuries. Emphasis is placed on injury-related expenses for ambulatory care and inpatient hospital care.

Specific comparisons are made by age, sex, race/ethnicity, health insurance status, and poverty status. The overall distribution of expenses is shown by type of care and source of payment for injury- and non-injury- related conditions.

The estimates are representative of the civilian noninstitutionalized population of the United States during calendar year 1997. A technical appendix at the end of this report provides definitions of the variables used in this report. It also gives a detailed description of the MEPS HC, including data collection methods, sample size, variable construction, and statistical procedures used to derive estimates. The standard errors for the tables and figures discussed in the text of this report are also shown in the appendix. Only differences between estimates that are statistically significant at the 0.05 level are discussed in this report.

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Definitions of Injury and Expenses

The standard definition of injury is the occurrence of sudden external forces resulting in trauma. Furthermore an injury may be unintentional (an accident) or intentional (violence or abuse). A single injury episode may result in several injuries or conditions. For example, a person may fall (the injury episode) and receive a concussion and a broken hip (the conditions related to the injury episode). This report examines 1997 expenses for medical treatment of conditions resulting from an injury episode regardless of whether the episode occurred in 1997 or prior to 1997. Approximately 41 percent of the injuries for which households reported receiving treatment during 1997 actually occurred in a prior year (data not shown).

The household respondent identified the date of the injury and the resulting conditions in the Condition Enumeration section of the MEPS HC Questionnaire and identified the number and type of provider visits in the Medical Event Sections. (See www.meps.ahrq.gov for details regarding the questionnaire.) This report contains estimates of the percent of the population reported to have an injury-related condition, not the percent with an injury per se. If a person did not have a medical provider visit and did not miss work or school because of an injury, such as a pulled muscle, the injury may not have been reported during the MEPS interview.

This report focuses on overall expenses in 1997 associated with injuries, as well as on expenses for ambulatory care and for inpatient hospital care, and estimates injury-related expenses as a proportion of total expenses for all care provided in these settings.

Ambulatory visits to medical providers in office and hospital settings, hospital inpatient care, home health care, and prescribed medicines are included in total expenses, but payments for over-the-counter-drugs, alternative care services, and telephone contacts with medical providers are not included. In contrast to other reports containing MEPS expenditure estimates (e.g., Thorpe and Machlin, 2000), this report excludes expenses for durable medical equipment and other miscellaneous items (eyeglasses, contact lenses, ambulance services, orthopedic items, hearing devices, prostheses, bathroom aids, medical equipment, disposable supplies, and other miscellaneous items or services) because it was not possible to determine from the survey questions which of these expenses were associated with injuries.

About 11 percent of all health care spending for the U.S. civilian noninstitutionalized population in 1997 was for injury-related conditions.

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Population Characteristics

Approximately 23 percent of the population (about 62 million persons) had a medical condition in 1997 that resulted from an injury (Table 1), and approximately 70 percent of those people (about 43 million) had some medical expense for that condition. About 16 percent of children under age 16 had at least one injury-related condition, compared to about one quarter of people 16 years of age and over. People ages 16-24 were less likely to have an expense associated with an injury-related condition than those under 16 or 45 and over.

Females (21.2 percent) were less likely than males (25.0 percent) to have had an injury-related condition. Males and females who had an injury-related condition were equally likely to have a related medical expense. Whites (25.4 percent) were more likely than blacks (17.3 percent), Hispanics (17.5 percent), and others (14.6 percent) to have an injury-related condition. The probability of having an injury-related condition did not vary by either insurance status or poverty status. However, the uninsured population under age 65 were the least likely to report an injury-related expense.

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Total Expenses for Injury-Related Conditions

An estimated $57.9 billion was spent on injury-related conditions for the U.S. civilian noninstitutionalized population in 1997 (Table 2). This was 10.8 percent of all health care spending during that year. For people with an injury-related expense, the mean expense for injury-related conditions was $1,330 but the median expense was only $241.

As a proportion of total expenses for all health care in 1997, injuries presented a greater burden for people ages 16-24 (25.6 percent) than for those under 16 or 45 and over. The mean expense for injury-related conditions was lowest for children under age 16 ($467).

An estimated $35.3 billion was spent on health care for injury-related conditions for males, higher than the $22.6 billion spent for women. The proportion of total expenses associated with injuries was about twice as high for males (14.9 percent) as for females (7.5 percent). Per capita expenses were about 62 percent higher for males ($266) than for females ($163), and mean expenses for people with injury-related conditions also were higher for males ($1,536) than for females ($1,101). Per capita injury-related expenses for whites were $246 in 1997, higher than for blacks ($122) or Hispanics ($137).

Among those under age 65, the proportion of total medical expenses attributable to injuries was approximately twice as high for the uninsured (24.3 percent) as for people with private coverage (12.4 percent) and people with public insurance (11.0 percent). There were no statistically significant differences among poverty status groups in the proportion of total expenses attributable to injuries, per capita expenses, or the mean or median expenses for injury-related conditions.

Figures 1 and 2 summarize the distribution of expenses for injury- and non-injury-related conditions, respectively, by type of care received. Ambulatory care accounted for a higher proportion of expenditures for injuries (51.3 percent) than non injury conditions (31.7 percent). The proportion of total expenses that went for inpatient hospital care was similar for injury- and non injury- related conditions (36.9 percent and 39.3 percent, respectively). Dental care and prescribed medicines made up a smaller proportion of expenses for injury-related conditions: dental care, 2.2 vs. 9.0 percent; prescribed medicines, 4.4 vs. 14.6 percent.

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Ambulatory Care Expenses

In 1997 expenses for injury-related care received by the U.S. civilian noninstitutionalized population in office-based settings and clinics, hospital outpatient departments, emergency rooms, and clinics owned and operated by hospitals amounted to approximately $29.7 billion, representing 16.4 percent of the ambulatory care expenses for all conditions (Table 3). The per capita expense for ambulatory care for injury-related conditions was $109. For those with an injury-related expense, the mean cost of ambulatory care for injury-related conditions was $787 and the median expense was $234. Injury-related expenses for ambulatory visits accounted for about one-quarter of all ambulatory expenses for people ages 16-24 (26.4 percent) and 25-44 (24.5 percent), a higher proportion than for the other age groups. Per capita expenses for ambulatory care were highest for people ages 25-44 ($146) and 45- 64 ($152). For persons with injury-related expenses, mean injury-related ambulatory care expenses also were highest for people ages 25-44 ($968) and 45-64 ($991).

Expenses for injury-related ambulatory care were higher for males ($17.0 billion) than for females ($12.7 billion). The proportion of total ambulatory care expenses associated with injuries was about 9 percentage points higher for males than for females (21.6 vs. 12.3 percent). However, differences in mean ambulatory care expenses for males and females were not statistically significant.

There were no statistically significant differences in the proportion of total ambulatory expenses associated with injuries by race/ethnicity. The mean injury-related expense was not statistically significantly different for blacks ($689) than for either whites or Hispanics, but it was significantly higher for whites ($813) than for Hispanics ($594).

For the population under 65 years old, the proportion of total ambulatory expenses attributed to injuries was higher for uninsured people (29.7 percent) than for those with private insurance (19.3 percent) or public insurance (16.1 percent). Differences in mean expenses by insurance status for this age group were not statistically significant. For people age 65 and over, the proportion of total ambulatory care expenses attributed to injuries was more than twice as high for those covered by Medicare only (9.5 percent) as for people covered by Medicare and other public insurance (4.3 percent).

There were no statistically significant differences in mean ambulatory care expenses for injury-related conditions by poverty status.

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Inpatient Hospital Expenses

The inpatient expense estimates shown in Table 4 include room and board charges, all hospital diagnostic and laboratory expenses associated with the basic facility charge, payments for separately billed physician inpatient services, and emergency room expenses incurred immediately prior to inpatient stays for injury-related conditions. Estimated expenses for inpatient services for injury-related conditions in 1997 were about $21.4 billion, which constituted 10.2 percent of expenditures for all inpatient care. The mean inpatient expense per person for people with an injury-related inpatient expense was $9,510, while the median expense was $5,473.

The amount spent on injury-related conditions for people ages 16-24 ($4.6 billion) amounted to an estimated 39.6 percent of all inpatient expenses for that age group.1 This proportion is substantially higher than the estimated proportions of total inpatient expenses for any other age group (ranging from 6.7 to 12.5 percent).

Males incurred about 72 percent of the total expenses for injury-related inpatient care in 1997— $15.3 billion, compared to only $6.1 billion for females. The proportion of inpatient expenses spent on injury-related care was approximately three times as high for males (15.4 percent) as for females (5.5 percent). Per capita expenses for injury-related inpatient care were nearly three times as high for males ($115) as for females ($44). The mean injury-related expense for those with an injury-related inpatient expense was about $4,300 higher for males than for females ($11,194 compared to $6,891).

The proportion of total inpatient expenses for injury-related care did not vary by race/ethnicity. However, per capita expenses for injury-related inpatient care for the white population ($93) were more than double expenses for the black population ($42), and the mean cost for inpatient care for injury-related conditions was substantially higher for whites than for blacks ($10,084 vs. $5,936).

There were no statistically significant differences in either the proportion of inpatient medical expenses attributable to injuries or the mean inpatient care expenses for injury-related conditions by either insurance status or poverty status.

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1
Relative standard errors of 30 percent or more.

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Source of Payment

Figures 3 and 4 summarize the percent distribution of expenses by source of payment for injury- and non injury- related conditions in 1997. Workers’ Compensation covered 14.4 percent of injury-related expenses. The proportion paid out of pocket was smaller for injury-related conditions than for non-injury-related conditions (11.5 percent vs. 19.1 percent). In contrast, the proportion of expenses paid by private insurance was similar for both injuries (45.2 percent) and noninjuries (44.0 percent), despite the noteworthy proportion of expenses for injuries paid by Workers’ Compensation.

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Summary

Approximately $57.9 billion was spent on injury-related care in 1997, constituting 10.8 percent of all health care spending during that year. This amount does not include payments for over-the-counter-drugs, alternative care services, telephone contacts with medical providers, or expenses for durable medical equipment or other miscellaneous items such as eyeglasses or ambulance services.

The average total expense for injury-related conditions was lowest for children under 16 ($467 per person with expense). However, as a proportion of total health care expenditures in 1997, injuries imposed a relatively high burden on people ages 16-24 years; about one-quarter of their total health care costs were attributed to injury-related conditions, a significantly higher share than for most other age groups. Furthermore, injury-related health care for this age group accounted for about 40 percent of all inpatient care expenses (about $4.6 billion),2 higher than for any other age group. Injury prevention strategies targeted toward this group of older teenagers and young adults may well be cost effective.

The proportion of total medical expenses associated with injuries was about twice as high for males (14.9 percent) as for females (7.5 percent). Males also incurred approximately 72 percent of all inpatient health care expenses for injury-related conditions ($15.3 billion). About 15.4 percent of all inpatient expenses for males were for injury-related conditions, approximately three times the proportion for females (5.5 percent). Injury-related conditions also accounted for approximately one-fifth (21.6 percent) of ambulatory care expenses for males compared to only 12.3 percent for females.

The impact of injuries on national health care expenditures raises important public policy issues. The extent of expenses for injury-related care is particularly significant when one considers that, unlike many major conditions, injuries often can be prevented or avoided by relatively inexpensive intervention programs (Bernstein and Schur, 1990). In Healthy People 2010 (Department of Health and Human Services (U.S.), 2000), the reduction of unintentional injuries, as well as violence and abuse, was identified as a priority area. Achievement of these national goals requires timely and accurate measures of the incidence of injury and expenses, including data on cause of injury and type of injury sustained, to form the basis for planning, analysis, and evaluation of injury control efforts (Miller and Lestine, 1996).

Workers' Compensation paid for about 14 percent of injury-related expenses in 1997.

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2
Relative standard errors of 30 percent or more.

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References

Bernstein AB, Schur CL. Expenditures for unintentional injuries among the elderly. J Aging Health 1990; 2:157- 78.

Cohen JW, Krauss NA. Spending and service use among people with the fifteen most costly medical conditions, 1997. Health Aff 2003 Mar./Apr.; 22(2):129-38.

Cohen SB. Sample design of the 1996 Medical Expenditure Panel Survey Household Component. Rockville (MD): Agency for Health Care Policy and Research; 1997. MEPS Methodology Report No. 2. AHCPR Pub. No. 97-0027.

Cohen SB. Sample design of the 1997 Medical Expenditure Panel Survey Household Component. Rockville (MD): Agency for Healthcare Research and Quality; 2000. MEPS Methodology Report No.11. AHRQ Pub. No. 01-0001.

Department of Health and Human Services (U.S.). Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. 2 vols. Washington: U.S. Government Printing Office; Nov. 2000.

Hoyert DL, Arias E, Smith BL, et al. Deaths: final data for 1999. Hyattsville (MD): National Center for Health Statistics; 2001. National Vital Statistics Reports; Vol. 49, No. 8.

Miller TR, Lestine DC. Patterns of U.S. medical expenditures and utilization for injury, 1987. Am J Public Health 1996; 86:89-93.

Thorpe JM, Machlin SR. Health care expenses in the U.S. civilian noninstitutionalized population, 1997. Rockville (MD): Agency for Healthcare Research and Quality; 2000. AHRQ Pub. No. 01-R086.

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Figures

Figures showing percent distributions of expenses:
1. For injury-related conditions by type of care
2. For non-injury-related conditions by type of care
3. For injury-related conditions by source of payment
4.  For non-injury related conditions by source of payment 

 

Figure 1. Percent distribution of expenses for injury-related conditions, by type of care: United States, 1997 Figure 2. Percent distribution of expenses for non-injury-related conditions, by type of care: United States, 1997
Figure 1.  Pie Chart - See text conversion below for details. Figure 2.  Pie Chart - See text conversion below for details.
Figure 1. Percent distribution of expenses for injury-related conditions, by type of care: United States, 1997
Ambulatory 51.3%
Inpatient 36.9%
Prescribed medicines 4.4%
Dental 2.2%
Home health 5.2%
Figure 2. Percent distribution of expenses for non-injury-related conditions, by type of care: United States, 1997
Ambulatory 31.7%
Inpatient 39.3%
Prescribed medicines 1464%
Dental 9.0%
Home health 5.52%

 

Figure 3. Percent distribution of expenses for injury-related conditions, by source of payment: United States, 1997

Figure 3.  Pie Chart - See text conversion below for details.

Figure 3. Percent distribution of expenses for injury-related conditions, by source of payment: United States, 1997
Private insurance 45.2%
Other 5.1%
Medicare 18.2%
Medicaid 5.6%
Workers' Compensation 14.4%
Out of pocket 11.5%

 

Figure 4. Percent distribution of expenses for non-injury-related conditions, by source of payment: United States, 1997

Figure 4.  Pie Chart - See text conversion below for details.

Figure 4. Percent distribution of expenses for non-injury-related conditions, by source of payment: United States, 1997
Private insurance 44.0%
Other 4.8%
Medicare 24.2%
Medicaid 7.9%
Out of pocket 19.1%

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Tables

Tables showing information on injury-related conditions:
1. Percent with conditions and percent incurring expenses
2. Total medical expenses
3. Ambulatory medical expenses
4. Inpatient medical expenses 

 

Table 1. Injury-related conditions and expenses—Percent of population with conditions and percent of those incurring expenses: United States, 1997

Population characteristic

Total population in thousands

People with injury-related conditions: Percent

People with injury-related conditions: Percent with expensea

Total

271,279

23.0

69.7

Age in years

Under16

63,621

16.1

72.9

16-24

33,470

24.8

63.8

25-44

83,707

25.7

67.8

45-64

56,295

25.8

71.2

65 and over

34,185

23.2

73.9

Sex

Male

132,605

25.0

69.4

Female

138,673

21.2

70.1

Race/ethnicity

Hispanic

31,111

17.5

67.7

Black

34,086

17.3

64.5

White

195,030

25.4

70.8

Other

11,052

14.6

61.9

Health insurance statusb (under age 65)

  Any private

176,046

23.9

70.8

  Public only

27,743

20.6

69.2

  Uninsured

33,304

20.5

58.4

Health insurance status (age 65 and over)

  Medicare only

8,550

22.5

74.5

  Medicare and private

22,028

23.9

74.1

  Medicare and other public

3,434

21.5

71.1

Poverty statusc

Poor

36,415

21.3

67.6

Near-poor

12,233

23.9

68.8

Low income

38,723

21.1

66.1

Middle income

89,981

23.7

71.0

High income

93,926

23.7

70.6

aPercent of those with injury-related condition(s) who incurred some expense for their condition(s) during 1997.

bUninsured refers to persons uninsured during the entire year. Public and private health insurance categories refer to individuals with public or private insurance at any time during the period. Individuals with both public and private insurance and those with CHAMPUS or CHAMPVA (Armed-Forces-related coverage) are classified as having private insurance.

cPoor refers to incomes at or below the Federal poverty line; near-poor, over the poverty line through 125 percent of the poverty line; low income, over 125 percent through 200 percent of the poverty line; middle income, over 200 percent to 400 percent of the poverty line; and high income, over 400 percent of the poverty line.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 1997.

Table 2. Total medical expensesa for injury-related conditions: United States, 1997

Population characteristic

Injury- related total expenses

(Total in thousands)

Injury-related total expenses

(Per capita)

Percent of total expenses due to injuryb

Expense per person with expense

(Median)

Expense per person with expense

(Mean)

Total

$57,878,383

$213

10.8

$241

$1,330

Age in years

Under 16

3,487,397

55

7.7

152

467

16-24

7,994,397

239

25.6

239

1,508

25-44

18,611,425

222

16.0

269

1,279

45-64

15,157,523

269

9.6

297

1,468

65 and over

12,627,641

369

6.8

283

2,155

Sex

Male

35,258,474

266

14.9

248

1,536

Female

22,619,909

163

7.5

233

1,101

Race/ethnicity

Hispanic

4,271,511

137

10.7

237

1,160

Black

4,165,598

122

8.8

253

1,094

White

47,932,351

246

11.0

240

1,369

Other

*1,508,922

*137

12.4

261

1,512

Health insurance statusc (under age 65)

  Any private

34,458,675

196

12.4

236

1,159

  Public only

5,506,037

198

11.0

234

1,395

  Uninsured

*5,286,030

*159

24.3

235

1,329

Health insurance status (age 65 and over)

  Medicare only

2,304,123

269

5.7

251

1,608

  Medicare and private

8,863,421

402

7.5

278

2,273

  Medicare and other public

1,460,097

425

5.5

452

2,775

Poverty statusd

Poor

6,956,216

191

9.5

269

1,323

Near-poor

2,530,134

207

7.6

214

1,258

Low income

8,944,592

231

12.3

286

1,660

Middle income

19,789,792

220

11.1

250

1,309

High income

19,657,648

209

11.0

225

1,250

aTotal medical expenses include inpatient hospital and physician services, ambulatory physician and nonphysician services, and prescribed medicines purchased during the year. Expenses for over-the-counter medications, alternative care services, and telephone contacts are not included. Expenses for durable medical equipment and other miscellaneous items are excluded because it was not possible to determine which of those expenses were associated with injuries.

bNumerator is total expenses for injuries. Denominator is total medical expenses for both injury- and non-injury-related conditions.

cUninsured refers to persons uninsured during the entire year. Public and private health insurance categories refer to individuals with public or private insurance at any time during the period. Individuals with both public and private insurance and those with CHAMPUS or CHAMPVA (Armed-Forces-related coverage) are classified as having private insurance.

dPoor refers to family incomes at or below the Federal poverty line; near-poor, over the poverty line through 125 percent of the poverty line; low income, over 125 percent through 200 percent of the poverty line; middle income, over 200 percent to 400 percent of the poverty line; and high income, over 400 percent of the poverty line.

*Relative standard error equal to or greater than 30 percent.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 1997.

Table 3. Ambulatory medical expensesa for injury-related conditions: United States, 1997

Population characteristic

Injury-related ambulatory expenses
(Total in thousands
)

Injury-related ambulatory expenses
(Per capita
)

Percent of total ambulatory expenses due to injuryb

Expense per person with expense
(Median)

Expense per person with expense
(Mean)

Total

$29,677,277

$109

16.4

$234

$787

           

Age in years

Under 16

2,494,470

39

13.3

154

366

16-24

3,175,994

95

26.4

230

654

25-44

12,234,467

146

24.5

271

968

45-64

8,565,435

152

15.7

285

991

65 and over

3,206,911

94

7.0

193

675

 

Sex

Male

17,023,157

128

21.6

236

851

Female

12,654,120

91

12.3

223

715

 

Race/ethnicity

Hispanic

1,881,957

60

15.1

200

594

Black

2,193,572

64

15.7

251

689

White

24,762,460

127

16.5

234

813

Other

839,288

76

19.8

265

942

 

Health insurance status (under age 65) c

  Any private

21,591,232

123

19.3

242

824

  Public only

2,500,292

90

16.1

205

740

  Uninsured

2,378,842

71

29.7

242

708

Health insurance status (age 65 and over)

  Medicare only

893,041

104

9.5

147

774

  Medicare and private

2,121,752

96

6.7

210

657

  Medicare and other  public

192,118

56

4.3

*244

522

 

Poverty statusd

Poor

2,724,914

75

13.3

251

616

Near-poor

1,299,641

106

14.9

196

762

Low income

4,250,933

110

17.9

252

919

Middle income

11,340,460

126

19.0

238

859

High income

10,061,330

107

14.7

215

732

aExpenses for visits to medical providers seen in office-based settings or clinics, hospital outpatient departments, emergency rooms (except visits resulting in an overnight hospital stay), and clinics owned and operated by hospitals, as well as expenses for events reported as hospital admissions without an overnight stay, are included.

bNumerator is ambulatory expenses for injuries. Denominator is total ambulatory expenses for both injury- and non-injury-related conditions.

cUninsured refers to persons uninsured during the entire year. Public and private health insurance categories refer to individuals with public or private insurance at any time during the period. Individuals with both public and private insurance and those with CHAMPUS or CHAMPVA (Armed-Forces-related coverage) are classified as having private insurance.

dPoor refers to family incomes at or below the Federal poverty line; near-poor, over the poverty line through 125 percent of the poverty line; low income, over 125 percent through 200 percent of the poverty line; middle income, over 200 percent to 400 percent of the poverty line; and high income, over 400 percent of the poverty line.

*Relative standard error equal to or greater than 30 percent.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 1997.

Table 4. Inpatient medical expensesa for injury-related conditions: United States, 1997

Population characteristic

Injury-related inpatient expenses
(Total in thousands
)

Injury-related inpatient expenses
(Per capita
)

Percent of total inpatient expenses due to injuryb

Expense per person with expense
(Median)

Expense per person with expense
(Mean)

Total

$21,372,738

$79

10.2

$5,473

$9,510

           

Age in years

Under 16

*818,725

*13

*6.7

*2,363

*5,090

16-24

*4,564,514

*136

*39.6

9,316

*16,966

25-44

4,419,911

53

12.5

4,040

6,060

45-64

4,762,106

85

7.9

5,908

9,631

65 and over

6,807,482

*199

7.6

6,140

11,468

Sex

Male

15,313,375

115

*15.4

*5,596

11,194

Female

6,059,363

44

5.5

5,033

6,891

Race/ethnicity

Hispanic

*1,569,956

*50

9.1

5,588

9,624

Black

1,425,844

42

6.9

4,628

5,936

White

18,081,799

93

10.8

5,525

10,084

Other

*295,140

*27

*7.5

*1,251

*5,808

Health insurance statusc (under age 65)

  Any private

9,880,695

56

10.8

4,862

7,935

  Public only

2,054,842

74

10.4

5,243

7,659

  Uninsured

*2,629,719

*79

*31.7

*8,791

*18,754

Health insurance status (age 65 and over)

  Medicare only

*755,467

*88

*3.8

4,539

7,026

  Medicare and private

*5,495,520

*249

*9.8

6,362

*13,199

  Medicare and other public

*556,496

*162

*4.3

6,124

7,979

Poverty statusd

Poor

2,874,196

79

8.9

5,203

7,712

Near-poor

*916,122

*75

*5.2

*5,835

7,753

Low income

3,099,773

80

10.9

7,826

9,533

Middle income

6,505,736

72

8.9

4,937

8,035

High income

*7,976,912

*85

13.9

5,420

12,833

aRoom and board and all hospital diagnostic and laboratory expenses associated with the basic facility charge, payments for separately billed physician inpatient services, and emergency room expenses incurred immediately prior to inpatient stays are included. Expenses for hospital discharges that did not involve an overnight stay, which are ambulatory expenses (Table 3), are excluded. Expenses for newborns who left the hospital on the same day as the mother are included in the mother’s record.

bNumerator is inpatient expenses for injuries. Denominator is total inpatient expenses for both injury-and non-injury-related conditions.

cFor health insurance status, uninsured refers to persons uninsured during the entire year. Public and private health insurance categories refer to individuals with public or private insurance at any time during the period. Individuals with both public and private insurance and those with CHAMPUS or CHAMPVA (Armed-Forces-related coverage) are classified as having private insurance.

dPoor refers to family incomes at or below the Federal poverty line; near-poor, over the poverty line through 125 percent of the poverty line; low income, over 125 percent through 200 percent of the poverty line; middle income, over 200 percent to 400 percent of the poverty line; and high income, over 400 percent of the poverty line.

*Relative standard error equal to or greater than 30 percent.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 1997.

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Technical Appendix

Technical Appendix
Survey Design   Standard Error Table A
Definitions of Terms Standard Error Table B
Significance Testing Standard Error Table C
Rounding Standard Error Table D
    Standard Error Table E
  Standard Error Table F

Data in this report are based on the combined samples for the second year of the 1996 panel of the Medical Expenditure Panel Survey Household Component (MEPS HC) and the first year of the 1997 MEPS HC. MEPS is cosponsored by the Agency for Healthcare Research and Quality (AHRQ) and the National Center for Health Statistics (NCHS). The focus of the MEPS HC is to collect detailed data on demographic characteristics, health conditions, health status, use of medical care services, charges and payments for those services, access to care, health insurance coverage, income, and employment of the U.S. civilian noninstitutionalized population. In other components of MEPS, data are collected on the use, charges, and payments reported by providers (Medical Provider Component) and the supply side of the insurance market (Insurance Component).

Survey Design

The sample for the 1996 MEPS HC was selected from respondents to the 1995 National Health Interview Survey (NHIS), and the sample for the 1997 MEPS HC was selected from the 1996 NHIS. NHIS, which is conducted by NCHS, provides a nationally representative sample of the U.S. civilian noninstitutionalized population and reflects an oversampling of Hispanics and blacks.

The MEPS HC collects data through an overlapping panel design. In this design, data are collected through a precontact interview that is followed by a series of five rounds of interviews over a period of 21/2 years. Interviews are conducted with one member of each family, who reports on the health care experiences of the entire family. Two calendar years of medical expenditure and utilization data are collected in each household and captured using computer-assisted personal interviewing (CAPI). This series of data collection rounds is launched again each subsequent year on a new sample of households to provide overlapping samples of survey data that will provide continuous and current estimates of health care expenditures.

The estimates of total expenditures in Tables 1-4 are based on 32,636 sample persons. They are weighted to develop population estimates for a total of 271,278,585 persons who were in the U.S. civilian noninstitutionalized population for part or all of 1997. For persons who were in the target population for the full year, all expenditures from January 1 through December 31, 1997, were included in the estimates. People with part-year information include newborns, people who died during the year, and people who resided in an institution, were in the military, or lived outside the country for part of the year. Expenditures for deceased persons were measured for the period from January 1 through the date of death, while those for newborns were measured from the date of birth through December 31. Expenses incurred during periods of full-time active-duty military service, institutionalization, or residency outside the country were not included.

This report provides estimates of expenditures in 1997 for the treatment of conditions that were reported to be attributable to an injury. The estimates include expenditures for conditions associated with injuries that occurred in 1997 as well as in prior years. Expenditures refer to payments for health care services, including out-of- pocket payments and payments by private insurance, Medicaid, Medicare, Workers’ Compensation, and other sources. Ambulatory visits to medical providers in office and hospital settings, hospital inpatient care, home health care, and prescribed medicines are included in total expenditures, while payments for over-the-counter drugs, alternative care services, and telephone contacts with medical providers are not included. In contrast to other reports containing MEPS expenditure estimates, expenses for durable medical equipment and other miscellaneous items (eyeglasses, contact lenses, ambulance services, orthopedic items, hearing devices, prostheses, bathroom aids, medical equipment, disposable supplies, and other miscellaneous items or services) are also excluded because it was not possible to determine from the survey questions which of these expenses were associated with injuries.

The estimates were developed using information collected in the conditions and medical events sections of the MEPS questionnaire (www.meps.ahrq.gov/survey_comp/survey.jsp). In the conditions section, respondents were asked to identify medical conditions that bothered sample persons during the period covered by the interview and identify conditions that were due to an injury. In the medical events sections, which collect information about ambulatory visits, inpatient hospitalizations, dental care, home health care, and prescribed medicines, respondents were asked to identify the conditions that were associated with each reported medical event. This information was used to link medical events to associated injury-related conditions. Estimates of expenditures for these events were based on a combination of data obtained from sample persons’ medical providers in the MEPS Medical Provider Component (used as first priority where available), the medical events sections of the MEPS HC, and imputation procedures for missing data. For detailed information on the MEPS sample design for Panel 1, see Cohen (1997). For detailed information on the MEPS sample design for Panel 2, see Cohen (2000). For information on response rates and estimation procedures see the Documentation File for HC-020 (http://www.meps.ahrq.gov/data_stats/download_data/pufs/h20/h20doc.pdf).

In the report, expenses are shown by selected population characteristics, including age, sex, race/ethnicity, health insurance status, and poverty status. (Definitions of these terms are given below.) In addition to total expenses by these characteristics, estimates on per capita expenses and spending for persons with expenses are provided. The per capita estimates were computed as the total injury-related expenses for a particular group divided by the total population of that group. The average number of conditions per injury episode was 1.04, indicating that the overwhelming majority of injuries were associated with only one condition. The standard errors for the estimates in this report are shown in Tables A-F.

Definitions of Terms

Type of Service

The types of service shown in Figures 1 and 2 are:

  • Hospital inpatient services - This category includes room and board and all hospital diagnostic and laboratory expenses associated with the basic facility charge, payments for separately billed physician inpatient services, and some emergency room expenses incurred immediately prior to inpatient stays. It excludes expenses for hospital discharges that did not involve an overnight stay, which are classified as ambulatory expenses.
     
  • Ambulatory services - This category includes expenses for visits to medical providers seen in office-based settings or clinics, hospital outpatient departments, emergency rooms (except some visits resulting in an overnight hospital stay), and clinics owned and operated by hospitals. It also includes expenses for events reported as hospital admissions without an overnight stay.
     
  • Prescribed medicines - This category includes expenses for all prescribed medications that were initially purchased or refilled during 1997, as well as expenses for diabetic supplies (some of which may have been purchased without a prescription).
     
  • Dental services - This category covers expenses for any type of dental care provider, including general dentists, dental hygienists, dental technicians, dental surgeons, orthodontists, endodontists, and periodontists.
     
  • Home health services - This category includes expenses for care provided by home health agencies and independent home health providers. Agency providers accounted for a large majority of the expenses in this category.

Source of Payment

The sources of payment shown in Figures 3 and 4 are classified as follows:

  • Out-of-pocket - These are expenses paid by the user or other family member.
     
  • Private insurance - This category includes payments made by insurance plans covering hospital and medical care (excluding payments from Medicare, Medicaid, and other public sources). Payments from Medigap plans or CHAMPUS and CHAMPVA (Armed-Forces-related coverage) are included. Payments from plans that provide coverage for a single service only, such as dental or vision coverage, are not included.
     
  • Medicare—Medicare is a federally financed health insurance plan for the elderly, persons receiving Social Security disability payments, and most persons with end-stage renal disease. Medicare Part A, which provides hospital insurance, is automatically given to those who are eligible for Social Security. Medicare Part B provides supplementary medical insurance that pays for medical expenses and can be purchased for a monthly premium.
     
  • Medicaid - Medicaid is a means-tested government program jointly financed by Federal and State funds that provides health care to those who are eligible. Program eligibility criteria vary significantly by State, but the program is designed to provide health coverage to families and individuals who are unable to afford necessary medical care.
     
  • Workers' Compensation—Workers - Compensation is a system, required by law, of compensating workers injured or disabled in connection with work. This system establishes the liability of an employer for injuries or sickness that arise over and in the course of employment. The benefits under this system generally include hospital and other medical payments and compensation for loss of income.
     
  • Other sources - This category includes payments from the Department of Veterans Affairs (except CHAMPVA); other Federal sources (Indian Health Service, military treatment facilities, and other care provided by the Federal Government); various State and local sources (community and neighborhood clinics, State and local health departments, and State programs other than Medicaid); various unclassified sources (e.g., automobile, homeowner’s, or other liability insurance, and other miscellaneous or unknown sources); Medicaid payments reported for people who were not reported as enrolled in the Medicaid program at any time during the year; and private insurance payments reported for people without any reported private health insurance coverage during the year.

Population Characteristics

In general, population characteristics are measured as of December 31, 1997, or the last date that the sample person was part of the civilian noninstitutionalized population living in the United States prior to December 31, 1997.
 

Race/Ethnicity
 

Classification by race and ethnicity is based on information reported in MEPS for each family member. Respondents were asked if the race of the sample person was best described as American Indian, Alaska Native, Asian or Pacific Islander, black, white, or other. They also were asked if the sample person’s main national origin or ancestry was Puerto Rican; Cuban; Mexican, Mexicano, Mexican American, or Chicano; other Latin American; or other Spanish. All persons whose main national origin or ancestry was reported in one of these Hispanic groups, regardless of racial background, are classified as Hispanic. The other race categories do not include Hispanic persons.

Comparisons by race/ethnicity are based on the following four race/ethnicity groups: white, black, Hispanic, and other.

Health Insurance Status

Individuals under age 65 were classified into the following three insurance categories.

  • Any private health insurance—Individuals with insurance that provides coverage for hospital and physician care at any time during the year (other than Medicare, Medicaid, or other public hospital/physician coverage) are classified as having private insurance. Persons with Armed-Forces related coverage—CHAMPUS/CHAMPVA (currently called TRICARE)—are also included because the number of sample persons in this group is small and this type of coverage is similar to private insurance. Insurance that provides coverage for a single service only, such as dental or vision coverage, is not included. Public coverage only—Individuals are considered to have public coverage only if they met both of the following criteria:
    • They were not covered by private insurance at any time during the year.
    • They were covered by one of the following public programs at any point during the year: Medicare, Medicaid, or other public hospital/physician coverage.
  • Uninsured—The uninsured are defined as persons not covered by Medicare, CHAMPUS/CHAMPVA, Medicaid, other public hospital/physician programs, or private hospital/physician insurance at any time during 1997. Individuals covered only by noncomprehensive State-specific programs (e.g., Maryland Kidney Disease Program, Colorado Child Health Plan) or private single-service plans (e.g., coverage for dental or vision care only, coverage for accidents or specific diseases) are not considered to be insured.
Individuals age 65 and over were classified into the following three insurance categories:
  • Medicare only.
  • Medicare and private insurance.
  • Medicare and other public insurance.
Poverty Status

Each person was classified according to the total 1997 income of his or her family. Within a household, all individuals related by blood, marriage, or adoption were considered to be a family. Personal income from all family members was summed to create family income. Possible sources of income included annual earnings from wages, salaries, bonuses, tips, and commissions; business and farm gains and losses; unemployment and Workers’ Compensation; interest and dividends; alimony, child support, and other private cash transfers; private pensions, individual retirement account (IRA) withdrawals, Social Security, and veterans’ payments; Supplemental Security Income and cash welfare payments from public assistance, Aid to Families with Dependent Children, and Aid to Dependent Children; gains or losses from estates, trusts, partnerships, S corporations, rent, and royalties; and a small amount of other income. Poverty status is the ratio of family income to the 1997 Federal poverty thresholds, which vary by family size and age of the head of the family. The categories are:

  • Poor - This refers to persons in families with income at or less than the poverty line.
  • Near-poor - This refers to persons in families with income over the poverty line through 125 percent of the poverty line.
  • Low income - This category includes persons in families with incomes over 125 percent through 200 percent of the poverty line.
  • Middle income - This category includes persons in families with income over 200 percent through 400 percent of the poverty line.
  • High income - This category includes persons in families with income over 400 percent of the poverty line.

Significance Testing

Tests of statistical significance were used to determine whether the differences between populations exist at specified levels of confidence or whether they occurred by chance. Differences were tested using Z-scores having asymptotic normal properties at the 0.05 level of significance. However, each individual significance test was conducted at the 0.05 level, which does not control the overall Type I error level at 0.05.

Rounding

Estimates presented in the tables are rounded as follows:

  • Percentages are rounded to the nearest 0.1 percentage point.
  • Mean and median expenditures are rounded to the nearest dollar.
  • Total expenditures are rounded to the nearest million dollar unit.

Some of the estimates for population totals of subgroups presented in the tables will not add exactly to the overall estimated population total as a consequence of rounding.

Table A. Standard errors for injury-related conditions and expenses—Percent of population with conditions and percent of those incurring expenses: United States, 1997

Corresponds to Table 1

Population characteristic
Standard Error
for percent with injury-related condition
Standard Error for percent with expensea

Total

0.35

0.70

     

Age in years

   

Under 16

0.61

1.59

16-24

0.96

1.92

25-44

0.59

1.23

45-64

0.72

1.27

65 and over

0.92

1.71

     

Sex

   

Male

0.50

0.94

Female

0.44

0.94

     

Race/ethnicity

   

Hispanic

0.63

1.80

Black

0.75

2.18

White

0.43

0.80

Other

1.44

4.92

     

Health insurance statusb (under age 65) 

  Any private

0.43

0.90

  Public only

0.92

1.96

  Uninsured

0.78

2.26

Health insurance status (age 65 and over)

  Medicare only

1.90

3.60

  Medicare and private

1.13

2.15

  Medicare and other public

2.17

5.12

     

Poverty statusc

   

Poor

0.85

1.81

Near-poor

1.44

3.13

Low income

0.69

1.84

Middle income

0.56

1.20

High income

0.54

1.25

aPercent of those with injury-related condition(s) who incurred some expense for their condition(s) during 1997.

bUninsured refers to persons uninsured during the entire year. Public and private health insurance categories refer to individuals with public or private insurance at any time during the period. Individuals with both public and private insurance and those with CHAMPUS or CHAMPVA (Armed-Forces-related coverage) are classified as having private insurance.

cPoor refers to incomes at or below the Federal poverty line; near-poor, over the poverty line through 125 percent of the poverty line; low income, over 125 percent through 200 percent of the poverty line; middle income, over 200 percent to 400 percent of the poverty line; and high income, over 400 percent of the poverty line.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 1997.

Table B.  Standard errors for total medical expensesa  for injury-related conditions: United States, 1997

Corresponds to Table 2

Population Characteristics Standard error for injury-related total expenses
(Total in thousands)
Standard error for injury-related total expenses
(Per capita)

Standard error for percent of total expenses due to injuryb

Standard error for average total expense per injury episode
(Median)

Standard error for average total expense per injury episode
(Mean)

Total

4,095,234

15

0.7

10

90

           

Age in years

         

Under 16

401,437

6

0.9

11

52

16-24

2,013,786

60

5.1

30

347

25-44

2,286,031

27

1.7

18

148

45-64

1,469,478

26

1.0

25

130

65 and over

2,179,019

63

1.1

36

355

           

Sex

         

Male

3,695,705

28

1.5

13

158

Female

1,364,078

10

0.5

15

61

           

Race/ethnicity

         

Hispanic

718,390

23

1.7

27

196

Black

455,118

13

1.0

28

107

White

4,168,822

22

0.9

12

114

Other

471,449

42

3.5

55

412

  

Health insurance statusc (under age 65) 

  Any private

2,945,704

17

1.0

11

97

  Public only

783,826

28

1.4

28

196

  Uninsured

1,764,058

53

6.4

28

440

Health insurance status (age 65 and over)

  Medicare only

456,719

52

1.1

74

267

  Medicare and private

2,126,987

96

1.7

45

526

  Medicare and other public

281,653

79

1.1

137

409

           

Poverty statusd

         

Poor

914,882

24

1.1

21

152

Near-poor

504,705

40

1.6

40

230

Low income

1,071,229

28

1.4

28

190

Middle income

1,841,138

21

1.2

19

129

High income

2,835,149

30

1.4

15

167

aTotal medical expenses include inpatient hospital and physician services, ambulatory physician and nonphysician services, and prescribed medicines purchased during the year. Expenses for over-the-counter medications, alternative care services, and telephone contacts are not included. Expenses for durable medical equipment and other miscellaneous items are excluded because it was not possible to determine which of those expenses were associated with injuries.

bNumerator is total expenses for injuries. Denominator is total medical expenses for both injury- and non-injury-related conditions.

cUninsured refers to persons uninsured during the entire year. Public and private health insurance categories refer to individuals with public or private insurance at any time during the period. Individuals with both public and private insurance and those with CHAMPUS or CHAMPVA (Armed-Forces-related coverage) are classified as having private insurance.

dPoor refers to family incomes at or below the Federal poverty line; near-poor, over the poverty line through 125 percent of the poverty line; low income, over 125 percent through 200 percent of the poverty line; middle income, over 200 percent to 400 percent of the poverty line; and high income, over 400 percent of the poverty line.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 1997.

Table C. Standard errors for ambulatory medical expensesa for injury-related conditions: United States, 1997

Corresponds to Table 3

Population characteristic

Standard error for injury-related ambulatory expenses
(Total in thousands
)

Standard error for injury-related ambulatory expenses
(Per capita
)

Standard error for percent of total ambulatory expenses due to injuryb

Standard error for expense per person with expense
(Median)

 

Standard error for expense per person with expense
(Mean)

Total

1,876,730

6.9

0.9

8

48

           

Age in years

         

Under 16

230,738

3.5

1.4

11

29

16-24

392,746

11.5

2.6

26

69

25-44

1,597,652

19.2

2.4

14

119

45-64

943,243

16.6

1.5

24

98

65 and over

422,764

12.2

0.9

26

75

           

Sex

         

Male

1,619,700

12.5

1.8

11

83

Female

745,358

5.2

0.7

13

37

           

Race/ethnicity

         

Hispanic

194,750

6.0

1.6

21

54

Black

240,351

6.9

1.6

22

61

White

1,807,884

9.4

1.1

10

58

Other

230,470

20.1

3.9

55

201

Health insurance statusc (under age 65)

  Any private

1,722,207

10.0

1.3

10

64

  Public only

334,918

11.3

1.8

21

84

  Uninsured

352,055

10.8

3.4

31

104

Health insurance status (age 65 and over)

  Medicare only

241,217

27.5

2.3

35

178

  Medicare and private

367,871

16.3

1.1

35

100

  Medicare and other public

45,023

13.1

1.2

75

115

           

Poverty statusd

Poor

303,521

7.6

1.2

20

51

Near-poor

363,914

28.8

4

28

203

Low income

753,914

20.1

2.8

25

160

Middle income

1,307,478

15.0

1.9

15

105

High income

827,082

8.3

1.1

16

52

aExpenses for visits to medical providers seen in office-based settings or clinics, hospital outpatient departments, emergency rooms (except visits resulting in an overnight hospital stay), and clinics owned and operated by hospitals, as well as expenses for events reported as hospital admissions without an overnight stay, are included.

bNumerator is total expenses for injuries. Denominator is total medical expenses for both injury- and non-injury-related conditions.

cUninsured refers to persons uninsured during the entire year. Public and private health insurance categories refer to individuals with public or private insurance at any time during the period. Individuals with both public and private insurance and those with CHAMPUS or CHAMPVA (Armed-Forces-related coverage) are classified as having private insurance.

dPoor refers to family incomes at or below the Federal poverty line; near-poor, over the poverty line through 125 percent of the poverty line; low income, over 125 percent through 200 percent of the poverty line; middle income, over 200 percent to 400 percent of the poverty line; and high income, over 400 percent of the poverty line.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 1997.

Table D.  Standard errors for inpatient medical expensesa for injury-related conditions, United States, 1997

Corresponds to Table 4

Population characteristic
Standard error for injury-related inpatient expenses
(Total in thousands)

Standard error for injury-related inpatient expenses
(Per capita)

Standard error for percent of total inpatient expenses due to injuryb

 

Standard error for expense per person with expense
(Median)

 

Standard error for expense per person with expense
(Mean)

Total

3,074,015

11.4

1.4

361

1,195

 

Age in years

Under 16

312,179

4.9

2.7

947

1,713

16-24

1,890,607

56.3

11.8

1,596

5,748

25-44

1,258,038

15.0

3.2

589

1,302

45-64

854,142

15.3

1.7

878

1,290

65 and over

2,055,873

60.1

2.2

870

2,843

Sex

Male

2,886,688

21.9

2.8

636

1,909

Female

904,081

6.5

0.9

587

758

Race/ethnicity

Hispanic

479,768

15.5

2.8

2,028

1,945

Black

330,467

9.7

1.7

792

956

White

3,213,791

16.6

1.8

472

1,544

Other

167,005

15.1

4.5

2,539

Health insurance statusc (under age 65)

  Any private

1,974,686

11.3

2.1

700

1,273

  Public only

513,717

18.8

2.5

658

1,583

  Uninsured

1,722,535

51.9

15.1

3,483

9,812

Health insurance status (age 65 and over)

  Medicare only

257,915

29.9

1.3

1,140

1,281

  Medicare and private

2,039,382

92.2

3.4

1,828

3,924

  Medicare and other public

176,455

50.1

1.4

1,107

1,208

Poverty statusd

Poor

718,637

19.5

2.1

833

1,648

Near-poor

290,564

24.0

2.0

2,932

1,785

Low income

670,616

17.3

2.3

687

1,377

Middle income

1,005,163

11.3

1.6

544

971

High income

2,594,223

27.5

4.0

1,218

3,689

aRoom and board and all hospital diagnostic and laboratory expenses associated with the basic facility charge, payments for separately billed physician inpatient services, and emergency room expenses incurred immediately prior to inpatient stays are included. Expenses for hospital discharges that did not involve an overnight stay, which are ambulatory expenses (Table 3), are excluded. Expenses for newborns who left the hospital on the same day as the mother are included in the mother's record.

bNumerator is inpatient expenses for injuries. Denominator is total medical expenses for both injury- and non-injury-related conditions.

cUninsured refers to persons uninsured during the entire year. Public and private health insurance categories refer to individuals with public or private insurance at any time during the period. Individuals with both public and private insurance and those with CHAMPUS or CHAMPVA (Armed-Forces-related coverage) are classified as having private insurance.

dPoor refers to family incomes at or below the Federal poverty line; near-poor, over the poverty line through 125 percent of the poverty line; low income, over 125 percent through 200 percent of the poverty line; middle income, over 200 percent to 400 percent of the poverty line; and high income, over 400 percent of the poverty line.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 1997.

 

Table E.  Standard errors for percent distributions of expenses for injury-related and non-injury-related conditions by type of care: United States, 1997

Corresponds to Figures 1 and 2

Type of condition Ambulatory care

Inpatient care

Prescribed medicines Dental
care
Home Health care

Injury-related

2.74

3.19

0.43

0.36

0.9

Non-injury-related

0.87

1.36

0.39

0.34

0.42

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey Household Component, 1997.

 

Table F.  Standard errors for percent distributions of expenses for injury-related and non-injury related conditions by source of payment: United States, 1997

Corresponds to Figures 3 and 4

Type of condition

Out of pocket

Private insurance

Medicare

Medicaid

Workers' Compensation

Other

Injury-related

0.81

3.38

2.98

0.66

2.3

0.95

Non-injury-related

0.59

1.07

1.02

0.44

0.68

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey Household Component, 1997.

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Suggested Citation:
Krauss, N. A., Machlin, S. R., and Adams, G. A. Research Findings #19: Health Care Expenses for Injuries: Estimates from the 1997 MEPS. December 2003. Agency for Healthcare Research and Quality, Rockville, MD. http://www.meps.ahrq.gov/data_files/publications/rf19/rf19.shtml