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.^top
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.
^top
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.
^top
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.
^top
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.
^top
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.
^top
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.
__________________
1 Relative standard
errors of 30 percent or more.
^top
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.
^top
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. __________________
2 Relative
standard errors of 30 percent or more.
^top
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.
^top
Figures
| 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. 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. 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. 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% |
|
^top
Tables
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.
top
Technical
Appendix
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.
^top
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 |
|
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