Untitled Document

Research Findings #21:
Health Care Expenses in the United States, 2000

by Trena M. Ezzati-Rice, M.S., David Kashihara, M.S., and Steven R. Machlin, M.S.

Abstract
This report from the Agency for Healthcare Research and Quality presents descriptive data on health care spending in the United States. Estimates are based on data from the 2000 Medical Expenditure Panel Survey (MEPS) and cover the civilian noninstitutionalized U.S. population. Estimates of total health care expenses and expenses for hospital inpatient services, ambulatory services (including office-based, hospital outpatient, and emergency room visits), prescription medicines, dental services, home health services, and other medical equipment and supplies are provided. The proportion of people with expenses; mean and median expenses; and the proportion of expenses paid by various sources, including out of pocket, Medicare, Medicaid, and private insurance, are shown for each type of service. In addition, distributions of expenses and sources of payment across the population are examined by selected demographic, geographic, and socioeconomic characteristics and by health insurance and health status.

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.

Suggested citation
Ezzati-Rice TM, Kashihara D, Machlin SR. Health care expenses in the United States, 2000. Rockville (MD): Agency for Healthcare Research and Quality; 2004. MEPS Research Findings No. 21. AHRQ Pub. No. 04-0022.

Contents
Introduction
Total Health Care Expenses
Hospital Inpatient Services
Office-Based Medical Provider Services
Hospital Outpatient Services
Emergency Room Services
Prescription Medicines
Dental Services
Home Health Services
Other Medical Equipment and Services
Summary
References

Tables showing expenses:
1. By event type
2. For total health services
3. For hospital inpatient services
4. For office-based medical provider services
5. For hospital outpatient services
6. For emergency room services
7. For prescription medicines
8. For dental services
9. For home health services
10. For other medical equipment and services

Technical Appendix
Definitions Standard Error Table D
Sample Design Standard Error Table E
Accuracy of Estimates Standard Error Table F
MEPS Expenditures Methodology Standard Error Table G
Standard Error Table A Standard Error Table H
Standard Error Table B Standard Error Table I
Standard Error Table C Standard Error Table J

Introduction
The Medical Expenditure Panel Survey (MEPS) collects detailed information on health care use, expenses, sources of payment, and insurance coverage from a nationally representative sample of the U.S. civilian noninstitutionalized (community) population. The health care system in the United States is continually changing in keeping with technological advancements in medical care and other factors. As a result, aggregate spending on health care, sources of payment for services and care, and specific expenses such as prescription medicines also change.

This report primarily provides estimates of expenses for health care based on data from the 2000 MEPS, but it also includes selected comparisons with 1996 MEPS estimates. The expense estimates for 2000 and 1996 presented and/or cited in this report were obtained from the compendia of tables available on the MEPS Web site at http://www.meps.ahrq.gov/data_public.htm. Expenses are defined as direct payments for health services and care received during the year. Expenses include out-of-pocket payments made by individuals and payments made by private insurance, Medicare, Medicaid, and other sources. Payments for over-the-counter drugs and some alternative care services are not included. Indirect payments not related to specific medical events, such as Medicaid Disproportionate Share and Medicare Direct Medical Education subsidies, are also not included.

The report provides aggregate estimates of health care expenses, as well as estimates for hospital inpatient services, hospital outpatient services, emergency room services, office-based medical provider services, prescription medicines, dental services, home health services, and other medical equipment and services. It also shows the proportion of people whose expenses were paid by various sources, including out of pocket, private insurance, Medicare, Medicaid, and other sources, for each type of service. In addition, distributions of expenses and sources of payment across the population are examined by selected demographic, socioeconomic, and geographic characteristics and by health status and health insurance status.

All differences between estimates discussed in the text are statistically significant at the 0.05 level. Detailed information on data sources and methods of estimation, along with definitions of the variables and categories used in this report, are included in the Technical Appendix.

Total Health Care Expenses

Type of Service

In 2000, the approximately 278.4 million people in the U.S. community population had health care expenses of about $627.9 billion. Table 1 shows that hospital inpatient care accounted for the largest share of total expenses (36.7 percent). The next largest share was for ambulatory services (31.9 percent), almost two-thirds of which were office-based medical services. Prescription medicines accounted for about 16.4 percent of total expenses. The remaining expenses were for dental care (8.8 percent), home health services (4.1 percent), and other medical equipment and services (2.1 percent).

Data on health expenses for 1996, shown on the MEPS Web site at http://www.meps.ahrq.gov/data_public.htm, reveal some interesting changes over the period 1996-2000. The percent of total health care expenses accounted for by prescription medicines rose from 11.9 percent in 1996 to 16.4 percent in 2000. On the other hand, the percent of total expenses going for home health services decreased from 6.2 percent in 1996 to 4.1 percent in 2000.

Source of Payment

In 2000, 83.5 percent of the U.S. community population had medical expenses (Table 2). The mean expense among those with expenses was $2,700. The median expense was much lower, $721. The large difference between the mean and median expenses results from a very small proportion of the population that accounts for a disproportionate share of the overall health care expenses. For example, in 2000, the 1 percent of the population with the highest health care expenses accounted for about one-quarter of the total health care expenses for the community population, and this level of skewed concentration of health care expenses has been fairly stable over time (Berk and Monheit, 2001). Because of the large difference between mean and median expenses, this report emphasizes medians rather than means when comparing subgroups.

Nearly one-fifth (19.4 percent) of total expenses were paid out of pocket, while the remainder was paid by third parties. Private health insurance was the largest third-party payer of medical expenses (40.5 percent), followed by Medicare (20.9 percent) and Medicaid (9.8 percent).

Demographic, Geographic, and Health Status Characteristics

In 2000, an estimated 95.5 percent of the population 65 and over had medical expenses. This compares to 81.8 percent of the population under 65 years old (Table 2). In addition to being more likely to have medical expenses, the older population also had much higher mean expenses than the younger population group ($6,140 versus $2,127). The largest single payer of medical expenses among the population 65 and over was Medicare (54.7 percent), while private health insurance was the largest source of payment (52.8 percent) for the under-65 population.

The median expense among those with an expense was lower for children under 6 ($267) than for children 6-17 years ($335). The proportion of expenses paid out of pocket was lower for children under 6 (10.3 percent) than for children 6-17 (27.7 percent).

A higher proportion of females than males had medical expenses (88.4 percent versus 78.4 percent). The median expense per person among females with an expense was $871, as opposed to $580 for males.

The proportion of people with medical expenses was lower for Hispanics (70.3 percent) and blacks (73.2 percent) than for whites/others (87.4 percent). (About 95 percent of the white/other category is white.) The median expense for people with an expense was lower for Hispanics ($386) and blacks ($411) than for whites/others ($833).

A higher percentage of out-of-pocket expenses were paid by whites/others (20.3 percent) and Hispanics (18.9 percent) than by blacks (12.2 percent). The percent of expenses paid by Medicaid was lower for whites (7.8 percent) than for blacks (18.9 percent) and Hispanics (19.3 percent).

While the percent of people with medical expenses did not differ between people residing in metropolitan statistical areas (MSAs) and those living in non-MSAs, the median medical expense was lower for people living in MSAs ($702, compared to $816 for people living in non-MSAs). The percent of people with medical expenses was lower in the South (81.6) and West (81.3) than in the Northeast (86.5) or Midwest (86.2).

People with better perceived health status were less likely to have an expense and had generally lower expenses. For example, 79.3 percent of people with excellent perceived health status had medical expenses in 2000, and the median expense for those who had expenses was $416. In contrast, 97.0 percent of people with poor perceived health status had medical expenses, with a median expense of $5,129. In the aggregate, higher proportions of expenses were paid out of pocket or by private insurance for those with better health status, whereas Medicare and Medicaid paid for larger proportions of expenses incurred by those in poorer health.

Insurance and Income

Among people under 65 years of age, 57.3 percent of the uninsured, 83.3 percent of those with only public insurance, and 85.9 percent of those with any private insurance had medical expenses. The median total expense for uninsured people was $305, lower than the figure for people with public insurance ($465) or any private insurance ($638). While out-of-pocket payments constituted a substantially higher proportion of expenses for the uninsured (40.4 percent) than for people with private insurance (21.0 percent) or public insurance (9.7 percent), other sources such as the Department of Veterans Affairs, public clinics, and other miscellaneous public and private sources paid for a substantial portion (59.6 percent) of medical expenses for the uninsured.

There was no statistically significant difference between the percent of elderly people with medical expenses by type of insurance coverage (ranging from 94.7 percent to 96.4 percent). The proportion of out-of-pocket spending was about two times higher for those with Medicare only (22.2 percent) than for those with Medicare and other public coverage (10.4 percent).

In general, people with lower income were less likely than people with higher income to incur medical expenses and had lower median expenses. For example, 77.3 percent of poor people (those with incomes below the Federal poverty level) had medical expenses, with a median expense of $524, while 88.2 percent of high-income people (those with incomes over 400 percent of the Federal poverty level) had medical expenses and their median expense was $815. (The positive relationship for median expenses did not hold for mean expenses, however.) People with lower income paid a smaller percentage of their health care expenses out of pocket and more of their expenses were paid by Medicaid. For example, poor people paid only 13.9 percent of their medical expenses out of pocket, while Medicaid paid 34.3 percent. In contrast, 22.3 percent of expenses for high-income people were paid out of pocket and 55.6 percent by private insurance.

Hospital Inpatient Services

The expenditure estimates for hospital inpatient services shown in Table 3 include room 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.

In 2000, 7.6 percent of the U.S. community population incurred hospital inpatient expenses totaling approximately $230 billion. Like total health care expenses, inpatient expenses are highly skewed, as evidenced by the approximately twofold difference between the mean expense per person with an expense ($10,917) and the median ($5,195).

Slightly more than three-quarters of hospital inpatient expenses were paid by private insurance and Medicare (40.7 and 35.9 percent, respectively), while out-of-pocket payments accounted for only 2.2 percent.

Demographic, Geographic, and Health Status Characteristics

People 65 years of age and over were 3.2 times as likely to incur hospital inpatient expenses as people under 65 (19.0 percent versus 5.9 percent). Also, the median expense per person with an expense was higher for the elderly than the non-elderly ($9,160 versus $4,372).

The largest source of payment for the elderly was Medicare, which accounted for 75.7 percent of the payments for inpatient services for this age group. The largest source of payment for the non-elderly was private insurance, which accounted for 59.4 percent of their expenses.

Females were more likely than males to have had hospital inpatient expenses (9.2 percent and 5.9 percent, respectively). However, the median expense per person with an expense was higher for males ($6,695) than for females ($4,556).

The proportion of the population with a hospital inpatient expense was higher for blacks (7.7 percent) and whites/others (7.9 percent) than for Hispanics (5.3 percent). There were no statistically significant differences by race/ethnicity in the proportion of inpatient expenses paid by Medicare or private insurance. However, the share of expenses paid out of pocket was higher for Hispanics (4.5 percent) than for whites/others (2.1 percent) or blacks (1.7 percent; note: relative standard error equal to or greater than 30 percent). Further, the percent of expenses paid by Medicaid was higher for blacks (16.4 percent) and Hispanics (18.4 percent) than for whites/others (7.9 percent).

The percent of people with hospital inpatient expenses was higher in non-MSA areas (9.1 percent) than in MSAs (7.2 percent). A higher percentage of people in the South and Midwest Regions had hospital inpatient expenses (8.3 and 8.1 percent, respectively) compared to people in the West Region (6.2 percent).

The more negative people’s perceived health status was, the more likely they were to incur inpatient expenses, and their mean and median expenses also increased. For example, 3.7 percent of people with excellent perceived health had hospital inpatient expenses and the median total expense for those who had an expense was $4,185. In contrast, 36.4 percent of people with poor perceived health had hospital inpatient expenses and their median expense of $8,876 was about two times that of people with excellent health status.

Insurance and Income

Among people under 65 years of age, hospital inpatient expenses were incurred by 3.5 percent of uninsured people, 12.4 percent of those with public insurance only, and 5.4 percent of those with any private insurance. The median expense for people with any private insurance ($4,925) was higher than the medians for public only insurance ($3,761) and uninsured ($3,426).

Among the elderly, people with Medicare and other public insurance were more likely to have hospital inpatient expenses (25.9 percent) than those with Medicare only (17.4 percent) or Medicare and private insurance (18.8 percent).

In general, people with lower incomes were more likely to have hospital inpatient expenses and lower median expenses. For example, among poor people, 11.3 percent had hospital inpatient expenses and the median expense for those with an expense was $4,377. In contrast, among people with high income, 5.7 percent had hospital inpatient expenses and the median expense was $6,477.

Office-Based Medical Provider Services

Expenses for visits to medical providers seen in office-based settings are shown in Table 4. In 2000, slightly more than two-thirds (68.8 percent) of the U.S. community population had office-based medical provider services and the expenses for these services totaled about $126 billion (Table 4). The mean expense for those with an expense was $657 and the median expense was $243. Private insurance was the single largest payer, accounting for 48.5 percent of total expenses for office-based medical care. The next two largest payer sources were out-of-pocket payments (17.8 percent) and payments by Medicare (16.8 percent).

Demographic, Geographic, and Health Status Characteristics

The proportion of people with office-based medical provider expenses was higher among the elderly (87.6 percent) than the non-elderly (66.1 percent). There was a generally positive relationship between age and median expenses per person. For example, the median expense per person with an expense was $490 for the elderly and $212 for the non-elderly. Among the elderly, the largest single source of payment was Medicare, which accounted for 59.0 percent of the payments for office-based care. Private insurance paid for another 18.6 percent and out-of-pocket spending was 11.4 percent. In this age group, Medicaid paid for only 3.3 percent of office-based care. In comparison, for the non-elderly, private insurance accounted for 58.1 percent of expenses for office-based care, out-of-pocket spending 19.9 percent, and Medicaid 6.6 percent.

More than three-quarters (78.5 percent) of children under 6 had expenses for office-based medical provider services, compared to 60.9 percent of children 6-17. The median expense per child was higher for children under 6 ($160) than for children 6-17 ($127).

Females were more likely than males to have expenses for office-based medical care (75.4 percent versus 61.9 percent). Females also had a higher median total expense per person than males ($278 versus $207). The proportion of expenses paid out of pocket was higher for females (19.0 percent) than males (16.1 percent).

Whites/others were more likely than blacks or Hispanics to have had expenses for office-based medical care (73.2 percent versus 56.0 and 55.0 percent, respectively), and they had higher median expenses ($268 versus $150 and $165, respectively). The proportion of expenses paid out of pocket was higher for Hispanics (19.4 percent) and whites/others (18.2 percent) than for blacks (12.0 percent). With respect to public coverage, Medicaid covered a higher proportion of expenses for blacks (13.5 percent) and Hispanics (12.4 percent) than for whites/others (4.6 percent), while Medicare covered a higher proportion of expenses for blacks (18.6 percent) and whites/others (17.1 percent) than for Hispanics (9.9 percent).

There were no statistically significant differences by MSA status in the percent with office-based expenses, the median expense, or the distribution of sources of payment. With respect to Census region, people in the South and West (66.8 and 65.2 percent) were less likely to have expenses for office-based medical care than people in the Northeast and Midwest (73.2 and 71.8 percent).

People with better perceived health status were less likely to have expenses for office-based care, and annual expenses for those receiving care tended to be lower. For example, 61.1 percent of people with excellent perceived health status had expenses for office-based medical care and the median expense for those who had an expense was $174. In contrast, 87.1 percent of people with poor perceived health status had expenses for office-based medical care, with a median expense of $676.

Insurance and Income

Among the non-elderly population, the proportion with expenses for office-based medical care was much lower for the uninsured (38.8 percent) than for those who had public insurance only (68.0 percent) or any private insurance (70.7 percent). The median expense of $137 for uninsured people was lower than the median expense for those with public only insurance ($163) or any private insurance ($226).

Among the elderly, the proportion with expenses for office-based care was higher for those with Medicare and private insurance (89.0 percent) than those with Medicare only (85.6 percent). The median expense for those with an expense was also higher for people with Medicare and private insurance ($548) than the Medicare-only group ($393).

People with lower income were less likely than those with higher income to incur expenses for office-based medical provider services, and the median expense was also lower. For example, 61.2 percent of poor people had expenses for office-based care and their median expense was $182. However, 73.9 percent of high-income people had these expenses and their median expense was $270. As income increased, the proportion of expenses paid out of pocket or by private insurance increased. For example, 10.5 percent of expenses among the poor were paid out of pocket and 18.9 percent were paid by private insurance. In comparison, 21.7 percent of the expenses for the high-income group were paid out of pocket and 60.6 percent by private insurance. About one-third (33.9 percent) of expenses for poor people were paid by Medicaid.

Hospital Outpatient Services

The expenses for hospital outpatient services shown in Table 5 comprise expenses for visits to both physicians and other medical providers seen in hospital outpatient departments, including payments for services covered under the basic facility charge and those for separately billed physician services. In 2000, 13.1 percent of the U.S. community population incurred about $55 billion in expenses for hospital outpatient services. The mean expense per person among those with an expense was $1,501 and the median expense was $555.

Approximately one-half of hospital outpatient services were paid for by private insurance (52.9 percent). Medicare was the second largest payer for hospital outpatient expenses (22.2 percent), while out-of-pocket payments and payments by Medicaid accounted for lower proportions-7.5 and 5.0 percent, respectively.

Demographic, Geographic, and Health Status Characteristics

Elderly people were 2.6 times as likely as non-elderly people to incur hospital outpatient expenses (28.3 percent versus 11.0 percent). The largest source of payment for the elderly was Medicare, which accounted for 56.5 percent of their expenses for hospital outpatient services. The largest source of payment for the non-elderly was private insurance, which accounted for 68.0 percent of their expenses.

Females were more likely than males to have hospital outpatient expenses (15.9 percent versus 10.2 percent). However, the median expense per person with an expense was higher for males ($683) than for females ($462).

The proportion of the population with any hospital outpatient expenses was lower for blacks (8.9 percent) and Hispanics (7.4 percent) than for whites/others (14.8 percent). The median expense was also lower for blacks ($383) than whites/others ($577).

A lower proportion of people incurred hospital outpatient expenses in the South (11.5 percent) and West (10.0 percent) than in the Northeast (16.4 percent) and Midwest (16.0 percent).

People with better perceived health status were less likely to incur expenses for hospital outpatient services and tended to have lower expenses. For example, 7.4 percent of people with excellent perceived health had hospital outpatient service expenses, and the median expense for those who had expenses was $362. In contrast, 30.8 percent of people with poor perceived health had these expenses, and their median expense was $1,098.

Insurance and Income

Among the non-elderly population, hospital outpatient expenses were incurred by a smaller proportion of the uninsured (5.0 percent) than by people with any private insurance (12.0 percent) or public insurance only (11.1 percent). Among the elderly, those with Medicare and private insurance were more likely to incur hospital outpatient expenses (32.5 percent) than either those with Medicare only (22.5 percent) or those with Medicare and other public insurance (24.5 percent).

In general, people with lower income were less likely to incur hospital outpatient expenses and had lower median expenses. For example, 10.0 percent of poor people had hospital outpatient expenses, with a median expense for those who had expenses of $377. However, 14.5 percent of people in the high-income category had these expenses, with a median expense of $581.

Emergency Room Services

In 2000, 11.6 percent of the U.S. community population incurred expenses of $19.2 billion for hospital emergency room services (Table 6). These expenses include payments for services covered under the basic facility charge and those for separately billed physician services, but exclude expenses for emergency room services followed by a hospital admission. The mean expense per person with an expense was $594 and the median was $315.

Private insurance paid for almost one-half of emergency room expenses (46.1 percent). Medicare was the second largest payer of emergency room expenses (17.9 percent), with lower shares for out-of-pocket (12.2 percent) and Medicaid payments (8.4 percent).

Demographic, Geographic, and Health Status Characteristics

The elderly were more likely to incur emergency room expenses than the non-elderly (16.8 percent versus 10.9 percent). The largest source of payment for emergency room expenses for the elderly was Medicare, which paid for 67.3 percent of their expenses. The largest source of payment for the non-elderly was private insurance, which paid for 55.1 percent of their expenses.

A slightly higher proportion of females (12.3 percent) than males (10.9 percent) had emergency room expenses.

The proportion of the population with emergency room expenses was lower for Hispanics (9.7 percent) than for blacks (13.0 percent) or whites/others (11.7 percent). Hispanics had a lower median expense per person with an expense ($260) than whites/others ($333).

The proportion of people with emergency room expenses was lower in the West Region (9.7 percent) than in the Northeast (12.2 percent), South (11.9 percent), or Midwest (12.7 percent).

In general, the better people’s perceived health status was, the less likely they were to incur emergency room expenses. For example, 8.9 percent of people with excellent perceived health, compared to 34.4 percent of people with poor perceived health, had emergency room expenses.

Insurance and Income

Among the non-elderly, the uninsured were the least likely to have emergency room expenses: only 7.4 percent of this group had expenses, compared to 17.7 percent of those with only public insurance and 10.4 percent of those with any private insurance.

In general, people with lower income were more likely to incur emergency room expenses. For example, 14.8 percent of poor people, but only 9.3 percent of people with high incomes, had emergency room expenses.

Prescription Medicines

The expenditure estimates for prescription medicines shown in Table 7 include expenses for all prescribed medicines initially purchased or otherwise obtained during 2000, including any refills.

In 2000, the U.S. community population incurred about $103.0 billion in expenses for prescription medicines. This figure represents an increase over the $65.3 billion (MEPS Web site) spent in 1996 ($71.7 billion when inflated to 2000 dollars using the overall Consumer Price Index). Despite this increase in total dollars spent, the proportion of the population with prescription medicine expenses decreased from 64.9 percent in 1996 to 62.3 percent in 2000.

The mean expense per person with an expense was $594 and the median was $186. Nearly half (46.1 percent) of prescription medicine expenses were paid out of pocket and about one-third (33.9 percent) of expenses were paid by private insurance. The next two largest sources of payment were Medicaid (11.2 percent) and Medicare (4.6 percent).

Demographic, Geographic, and Health Status Characteristics

The elderly were 1.5 times more likely than younger people to incur prescription medicine expenses (88.3 percent versus 58.5 percent). The median expense per person with an expense was $695 for the elderly, but only $136 for the non-elderly. For elderly people, the largest source of payment was out of pocket, which accounted for 56.6 percent of their expenses for prescribed medicines. For the non-elderly, the largest payment sources were private insurance (42.4 percent) and out of pocket (41.0 percent).

Females were more likely to incur prescription medicine expenses than males (69.2 percent compared to 54.9 percent). The median expense per person with an expense was $219 for females and $146 for males.

Blacks (50.8 percent) and Hispanics (47.2 percent) were less likely to incur prescription medicine expenses than whites/others (66.6 percent). The median prescription medicine expense per person with an expense was lower for blacks ($125) and Hispanics ($92) than for whites/others ($214).

The median prescription medicine expense per person with an expense was $174 for people living in an MSA and $239 for people not living in an MSA. People in the West Region were the least likely to have prescription medicine expenses: 58.1 percent versus 62.6 percent in the South, 64.1 percent in the Midwest, and 64.3 percent in the Northeast. People in the West Region also had the lowest median prescription medicine expenses: $135 versus $172 in the Northeast, $204 in the Midwest, and $223 in the South.

People with better perceived health status were less likely than people in poor health to incur prescription medicine expenses and their total expenses were also lower. For example, 49.0 percent of people with excellent perceived health had prescription medicine expenses and their median expense per person with an expense was $80. In contrast, 92.2 percent of people with poor perceived health had prescription medicine expenses, with a median expense of $1,230.

Insurance and Income

Among the non-elderly, the percent of people with prescription medicine expenses was smallest for the uninsured: 37.6 percent, compared to 62.1 percent for those with public only insurance and 61.7 percent for those with any private insurance. The median expense for those with an expense was also lowest for uninsured people: $89, compared to $119 for those with public only insurance and $144 for those with any private insurance.

Among the elderly, those with Medicare and other public insurance had higher median expenses ($934) than those with either Medicare only ($627) or Medicare and private insurance ($708).

Poor people had a lower likelihood of having prescription medicine expenses (58.6 percent) than high-income people (64.8 percent), and the median expense was less among poor people ($139) than for people with high income ($205). (This positive relationship did not hold for mean expenses.)

Dental Services

The expenditure estimates for dental services shown in Table 8 include expenses for any type of dental care provider. In 2000, 40.1 percent of the U.S. community population incurred a total of about $55.6 billion in expenses for dental services, an increase over the $43.1 billion (MEPS Web site) spent in 1996 ($47.4 billion when inflated to 2000 dollars using the overall Consumer Price Index).

The mean expense per person with an expense increased from $384 in 1996 ($421 when inflated to 2000 dollars using the overall Consumer Price Index) to $498 in 2000. The median expense per person with an expense increased from $137 in 1996 ($150 when inflated to 2000 dollars using the overall Consumer Price Index) to $168 in 2000. About half (49.3 percent) of the payments for dental expenses were out of pocket and another 42.2 percent of dental expense payments came from private insurance.

Demographic, Geographic, and Health Status Characteristics

The median total expense per person with a dental expense was $196 for the elderly and $164 for the non-elderly. For the elderly, the largest source of payment for dental expenses (76.7 percent) was out of pocket. For the non-elderly, the largest source of payment was private insurance (46.3 percent), followed closely by out-of-pocket payments (45.2 percent).

Females were more likely than males to have dental expenses (43.2 percent versus 36.9 percent). Whites/others (45.0 percent) were much more likely than blacks (26.0 percent) or Hispanics (24.4 percent) to have dental expenses. Blacks ($107) and Hispanics ($128) also had lower median dental expenses than whites/others ($178).

The proportion of people using dental services was greater in the Northeast (45.7 percent) and Midwest (45.0 percent) than in the South (35.4 percent) and West (37.8 percent). The median total dental expense per person with an expense also varied by region: lower in the South ($154) and Midwest ($149) and higher in the Northeast ($185) and West ($200). The median total dental expense was $170 for people living in MSAs and $151 for people not living in MSAs.

The proportion of people with dental expenses was higher for people with excellent (42.6 percent) or very good (42.8 percent) perceived health than those in poor health (26.4 percent). However, there was no statistically significant difference between the groups in the median expense for those who had an expense.

Insurance and Income

Among the non-elderly, 17.5 percent of those who were uninsured, 27.9 percent of those with only public insurance, and 46.1 percent of those who had any private insurance had dental expenses. The median expense among those who had an expense was $151 for people who were uninsured. In comparison, the median expense was $87 for those with public only insurance and $174 for those with any private insurance. Among the elderly, 32.6 percent of those with Medicare only, 47.9 percent of those with Medicare and private insurance, and only 16.4 percent of those with Medicare and other public insurance had dental expenses.

In general, people with lower income were less likely than higher income people to incur dental expenses, and their median expenses were lower. For example, 24.8 percent of poor people had dental expenses, and the median expense was $105. However, 51.6 percent of people with high income had dental expenses, and their median expense was $185.

Home Health Services

The expenditure estimates for home health services shown in Table 9 include expenses for care provided by home health agencies and paid independent home health providers. Even though a relatively small percentage of the community population had home health expenses (1.8 percent), expenses for home health ranked second in terms of mean and median expenses per person with an expense, with a mean expense of $5,136 and a median of $1,710. Only hospital inpatient services (Table 3) had higher per-user expenses.

Medicaid paid for the highest proportion of home health service expenses (48.2 percent), followed by Medicare (25.6 percent) and out of pocket (12.4 percent). The share of home health expenses covered by Medicaid tripled from 1996 (16.2 percent) to 2000 (48.2 percent). The share covered by Medicare decreased from 52.6 percent in 1996 (MEPS Web site) to 25.6 percent in 2000, while the proportion paid out of pocket was similar in 2000 and 1996, about 12 percent.

Demographic, Geographic, and Health Status Characteristics

The elderly were more likely to have home health expenses than the non-elderly (8.7 percent versus 0.8 percent). A lower proportion of the elderly had expenses in 2000 (8.7 percent) than in 1996 (13.2 percent). The share of home health expenses among the elderly paid by Medicare, the primary source of payment for home health services, decreased significantly, from 58.9 percent in 1996 to 38.4 percent in 2000. In addition, Medicaid payments for home health expenses for the elderly rose from 11.2 percent in 1996 to 28.1 percent in 2000. Another 21.2 percent of home health expenses for the elderly were paid out of pocket.

Females (2.1 percent) were more likely than males (1.5 percent) to have home health expenses; however, the median expense per person did not differ for females and males. Hispanics (1.0 percent) were less likely than whites/others (1.9 percent) to incur home health expenses; there were no statistically significant differences between blacks and the whites/others group or blacks and Hispanics.

There was no statistically significant difference in the proportion of people with home health expenses in terms of place of residence-either MSA status or region.

Insurance and Income

Non-elderly people with public only insurance were about seven times as likely as those with private insurance to incur expenses for home health services-3.7 percent versus 0.5 percent. Among elderly people, those with Medicare and other public coverage were about three times as likely as those with Medicare and private coverage to have expenses for home health services-22.2 percent versus 6.9 percent.

The proportion with home health expenses was lower among high-income people (1.0 percent) than among the poor (3.1 percent) or near-poor (3.7 percent).

Other Medical Equipment and Services

The expenditure estimates for other medical equipment and services shown in Table 10 include expenses for eyeglasses, contact lenses, ambulance services, orthopedic items, hearing devices, prostheses, bathroom aids, medical equipment, disposable supplies, alterations/modifications, and other miscellaneous items or services that were obtained, purchased, or rented during the year. About two-thirds of the expenses in this category were for vision-related items. In 2000, about 19 percent of the community population had expenses for other medical equipment and services, totaling about $13.4 billion. As with other health care expenses, the median expense ($180) was less than the mean expense ($260). Approximately 71 percent of the total expenses were paid out of pocket, by far the most common source of payment.

Demographic, Geographic, and Health Status Characteristics

Elderly people were more likely than non-elderly people to have other medical expenses (26.7 percent versus 17.4 percent), and they had higher median expenses for those with an expense ($200 versus $178). Other medical expenses were more common for whites/others (20.6 percent) than either blacks (12.9 percent) or Hispanics (11.8 percent). They were also more common for people in fair health (24.1 percent) or poor health (31.9 percent) than for those in good, very good, or excellent health (19.4, 19.0, and 15.1 percent, respectively).

Insurance and Income

Among the non-elderly, the percent with other medical expenses was higher for people with any private insurance (19.2 percent) than those with public only (14.7 percent) or the uninsured (9.8 percent). High-income people were more likely than poor people to have other medical expenses (22.9 percent versus 14.0 percent), and they paid a higher percentage out of pocket (75.6 percent versus 52.4 percent).

Summary

In 2000, about 84 percent of the approximately 278.4 million people living in the U.S. civilian noninstitutionalized population at any time during the year had at least one health care expense. Aggregate health care spending by this population was approximately $627.9 billion. The mean expense per person with an expense was $2,700. The median expense was much lower at $721, a differential primarily caused by the highly skewed distribution of medical expenses resulting from a small proportion of the population that accounts for a disproportionate share of high health care expenses.

Hospital inpatient care accounted for the largest share of total health care expenses (36.7 percent), and another 20.1 percent of the total was for office-based medical provider services. The nearly $103 billion spent on prescription medicines was the third largest share of total expenses (16.4 percent).

Hospital inpatient services ranked first in terms of mean and median expenses per person with an expense ($10,917 and $5,195, respectively). Even though home health services accounted for only 4.1 percent of total expenses, this category of health care ranked the second highest in terms of mean and median expenses per person with an expense, with a mean expense of about $5,100 and a median of about $1,700.

The largest source of payment for health care expenses was third-party payers. Specifically, private health insurance accounted for 40.5 percent of total payments, followed by two public sources of payment: Medicare (20.9 percent) and Medicaid (9.8 percent). Another 19.4 percent of health care expenses were paid out of pocket by individuals and/or family members.

The proportion of expenses paid by different sources varied by type of service provided. For example, 49.3 percent of dental expenses and 46.1 percent of prescription medicine expenses were paid out of pocket, while private insurance and Medicare were the largest sources of payment for hospital inpatient services (40.7 and 35.9 percent, respectively) and hospital outpatient services (52.9 and 22.2 percent, respectively).

The percent of people with an expense, as well as the mean and median level of spending, varied by demographic characteristics, income, health status, and geographic residence. Regardless of age, the majority of people had at least one health care expense during 2000. Specifically, 95.5 percent of the population age 65 and over had medical expenses and 81.8 percent of the under-65 population had expenses. The mean expense for the elderly was $6,140, compared to $2,127 for the non-elderly. With respect to race/ethnicity, the proportion of people with medical expenses was lower for Hispanics (70.3 percent) and blacks (73.2 percent) than for whites/others (87.4 percent). Further, among those with expenses, the median expenses of $386 for Hispanics and $411 for blacks were lower than the $833 for whites/others. In the aggregate, people with better perceived health status were less likely to have health care expenses and they had generally lower expenses. For example, the median expense for those with excellent perceived health status was $416, compared to $5,129 for people with poor perceived health status. People with lower incomes were less likely to incur medical expenses and their median expenses were also lower than those of high-income people. For example, 77.3 percent of poor people had medical expenses (median of $524), while 88.2 percent of high-income people had expenses (median of $815). Variations in these patterns were observed across the various service types.

In summary, the health expenditure data from the 2000 MEPS indicate that the levels of expenses, proportions of people with expenses, and sources of payment vary by type of service and by sociodemographic, geographic, health insurance, and health status characteristics. These estimates, along with estimates from past and future MEPS surveys, provide researchers and health policymakers with critical data to study trends in health care expenses and the distribution of expenses and sources of payment in the U.S. population.

References

Berk M, Monheit A. The concentration of health care expenditures revisited. Health Affairs 2001; 20(2):9-18.

Cohen J. Design and methods of the Medical Expenditure Panel Survey Household Component. Rockville (MD):Agency for Health Care Policy and Research; 1997. MEPS Methodology Report No. 1. AHCPR Pub. No. 97-0026.

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.

Cohen SB. Design strategies and innovations in the Medical Expenditure Panel Survey. Medical Care 2003; 41(7):5-12.

Machlin SR, Taylor AK. Design, methods, and field results of the 1996 Medical Expenditure Panel Survey Medical Provider Component. Rockville (MD):Agency for Healthcare Research and Quality; 2000. MEPS Methodology Report No. 9. AHRQ Pub. No. 00-0028.

Moeller JF, Stagnitti MN, Horan E, et al. Outpatient prescription drugs: data collection and editing in the 1996 Medical Expenditure Panel Survey (HC-010A). Rockville (MD):Agency for Healthcare Research and Quality; 2001. MEPS Methodology Report No. 12. AHRQ Pub. No. 01-0002.

Selden TM, Levit KR, Cohen JW, et al. Reconciling medical expenditure estimates from the Medical Expenditure Panel Survey and the NHA, 1996. Health Care Financing Review 2001 Fall; 23(1):161-78.

Zuvekas SH, Cohen JW. A guide to comparing health care expenditures in the 1996 MEPS to the 1987 NMES. Inquiry 2002 Spring; 39(1):76-86.

Table 1. Expenses by event type: United States, 2000
Expenses
--------------------------------------------------------------------------------

Payments (in billions)
--------------------------------------------------------------------------------
Percent distribution
--------------------------------------------------------------------------------

Event Type All
Expenses Ambulatory
Expenses All
Expenses Ambulatory
Expenses
Totala $627.9 NA 100.0 NA
Hospital inpatientb 230.2 NA 36.7 NA
Ambulatoryc 200.1 NA 31.9 100.0
Office-based visits NA $125.9 NA 62.9
Hospital outpatient visits NA 54.9 NA 27.4
Emergency room visits NA 19.2 NA 9.6
Prescription medicinesd 103.0 NA 16.4 NA
Dentale 55.6 NA 8.8 NA
Home healthf 25.6 NA 4.1 NA
Other medicalg 13.4 NA 2.1 NA
aTotal includes inpatient hospital and physician services, ambulatory physician and nonphysician services, prescribed medicines, home health services, dental services, and various other medical equipment, supplies, and services that were purchased or rented during the year. Over-the-counter medications, alternative care services, and telephone contacts are excluded.

bHospital admissions that did not involve an overnight stay are included. Expenses include room 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. Events for newborns who left the hospital on the same day as the mother are treated as separate events, but associated expenses are included in expense estimates.

cEvents and expenses for both physician and nonphysician 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 are included.

dAll prescribed medicines initially purchased or otherwise obtained during 2000, as well as refills and free samples, are included.

eServices provided by general dentists, dental hygienists, dental technicians, dental surgeons, orthodontists, endodontists, and periodontists are included.

fExpenses for care provided by home health agencies and independent home health providers are included. Most home health expenses (87.5 percent) were for agency providers.

gExpenses for eyeglasses, ambulance services, orthopedic items, hearing devices, prostheses, bathroom aids, medical equipment, disposable supplies, alterations/modifications, and other miscellaneous items or services that were obtained, purchased, or rented during the year are included.

NA—Not applicable.

Note: These estimates are for a target population of approximately 278.4 million persons who were in the civilian noninstitutionalized population for all or part of 2000. Percents may not add to 100 because of rounding.
Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table 2. Total health servicesa - Median and mean expenses per person with expenses and distribution
of expenses source of payment: United States, 2000
Expense per person with an expense
--------------------------------------------------------------------------------
Percent distribution of total
expenses by source of payment

--------------------------------------------------------------------------------

Population
characteristic
Population
(in thousands) Percent
with expense Median Mean Total
expenses (in millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Total 278,406 83.5 $721 $2,700 $627,897 19.4 40.5 20.9 9.8 9.5

Age in years
Under 65 243,624 81.8 586 2,127 423,933 20.3 52.8 4.6 12.3 10
Under 6 24,126 86.7 267 1,124 23,497 10.3 51.3 *0.3 31.6 6.5
6-17 48,405 80 335 1,117 43,241 27.7 49.1 *0.1 16.4 6.7
18-44 109,021 77.7 575 1,905 161,419 19.9 51.6 *3.9 14.2 10.4
45-64 62,072 88.5 1,287 3,562 195,776 20.2 54.7 6.7 7.5 10.9
65 and over 34,782 95.5 2,278 6,140 203,964 17.5 15 54.7 4.5 8.3
Sex
Male 135,882 78.4 580 2,633 280,592 16.8 40.7 21.4 8.5 12.6
Female 142,524 88.4 871 2,757 347,305 21.5 40.4 20.5 10.8 6.9
Race/ethnicity
White and other 209,401 87.4 833 2,832 518,202 20.3 41.7 21.1 7.8 9
Black 35,049 73.2 411 2,647 67,926 12.2 33.3 22.1 18.9 13.5
Hispanic 33,955 70.3 386 1,749 41,770 18.9 37.4 16.1 19.3 8.3
Health insurance statusd
Under age 65:
Any private 182,658 85.9 638 2,042 320,512 21 69.8 1.5 1.7 6
Public only 28,622 83.3 465 3,170 75,629 9.7 *0.0 19.7 61.8 8.7
Uninsured 32,344 57.3 305 1,500 27,793 40.4 *0.0 *0.0 *0.0 59.6
Age 65 and over:
Medicare only 11,515 94.7 2,033 5,206 56,798 22.2 *0.0 62.5 *0.0 15.3
Medicare and private 19,570 95.9 2,362 6,276 117,811 17 25.9 51.7 *0.5 4.8
Medicare and other public 3,568 96.4 3,094 8,324 28,624 10.4 *0.0 53.1 29.8 6.7
Poverty statuse
Poor 32,053 77.3 524 3,173 78,641 13.9 13.2 26 34.3 12.6
Near-poor 12,196 78.1 729 2,967 28,263 17.3 11.3 35.2 27.2 9
Low income 37,059 79.1 690 3,134 91,838 17.7 25.4 32.1 14.7 10.1
Middle income 90,343 82.7 664 2,555 190,908 19 44.5 20.5 4.4 11.6
High income 106,754 88.2 815 2,529 238,247 22.3 55.6 13.5 *2.1 6.5
Metropolitan statistical area (MSA)
MSA 226,861 83.3 $702 $2,641 $498,915 19.2 40.6 20.4 9.8 9.9
Non-MSA 51,545 84.6 816 2,958 128,982 19.9 40 22.9 9.5 7.8
Census region
Northeast 52,636 86.5 802 2,716 123,622 19 40.9 22.1 10.7 7.2
Midwest 64,536 86.2 737 2,900 161,354 18.5 39.3 22.2 8.6 11.4
South 97,373 81.6 727 2,747 218,206 20.3 39.7 21.2 9 9.7
West 63,861 81.3 646 2,402 124,715 19.2 43 17.4 11.8 8.7
Perceived health status
Excellent 87,890 79.3 416 1,281 89,341 26.3 52.9 7.5 6.7 6.6
Very good 93,499 83.6 650 1,901 148,573 24.4 48.5 12.2 6.2 8.7
Good 67,922 84.5 994 2,856 163,835 19.7 44.7 16.9 9.4 9.4
Fair 20,666 93.3 2,432 6,689 128,956 14.8 29.5 33.6 14 8.1
Poor 7,720 97 5,129 12,051 90,204 11.5 23.3 36.4 13.8 *14.9
aInpatient hospital and physician services, ambulatory physician and nonphysician services, prescribed medicines, home health services, dental services, and various other medical equipment and services that were purchased or rented during the year are included. Over-the-counter medications, alternative care services, and telephone contacts are excluded.

bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

cOther includes payments from the Department of Veterans Affairs (except TRICARE); 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); Workers’ Compensation; various unclassified sources (e.g., automobile, homeowner’s, or other liability insurance, and other miscellaneous or unknown sources); Medicaid payments reported for persons who were not reported as enrolled in the Medicaid program at any time during the year; and private insurance payments reported for persons without any reported private health insurance coverage during the year.

dUninsured 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 TRICARE (Armed-Forces-related coverage) are classified as having private insurance.

ePoor—persons in families with income less than 100 percent of the poverty line, including those whose losses exceeded their earnings, resulting in negative income; near-poor—persons in families with income from 100 percent to less than 125 percent of the poverty line; low income—persons in families with income from 125 percent to less than 200 percent of the poverty line; middle income—persons in families with income from 200 percent to less than 400 percent of the poverty line; high income—persons in families with income at or over 400 percent of the poverty line.

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

Note: Restricted to civilian noninstitutionalized population. Percents may not add to 100 because of rounding.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table 3. Hospital inpatient servicesa?Median and mean expenses per person with expensed and distribution
of expensed by source of payment: United States, 2000
Expense per person with an expense
--------------------------------------------------------------------------------
Percent distribution of total expenses
by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in thousands) Percent with expense Median Mean Total
expenses (in millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Total 278,406 7.6 $5,195 $10,917 $230,229 2.2 40.7 35.9 9.8 11.4

Age in years
Under 65 243,624 5.9 4,372 9,437 136,609 2.9 59.4 8.6 15.7 13.4
Under 6 24,126 5.2 3,367 7,517 9,494 *3.7 62.9 *0.1 *26.0 *7.3
6-17 48,405 2 — — — — — — — —
18-44 109,021 6.8 4,128 7,080 52,452 4 55 *7.6 20.4 13
45-64 62,072 7.8 6,491 14,175 68,577 1.8 62.6 11.2 9 *15.4
65 and over 34,782 19 9,160 14,157 93,620 1.2 13.3 75.7 1.3 8.5
Sex
Male 135,882 5.9 6,695 14,676 116,831 1.9 40.9 33.8 9.3 14.1
Female 142,524 9.2 4,556 8,638 113,398 2.5 40.5 38 10.4 8.6
Race/ethnicity
White and other 209,401 7.9 5,249 10,928 181,305 2.1 41.3 37.7 7.9 11
Black 35,049 7.7 5,339 12,386 33,238 *1.7 36.4 29.8 16.4 15.7
Hispanic 33,955 5.3 4,320 8,644 15,686 4.5 42.6 27.4 18.4 7.1
Health insurance statusd
Under age 65:
Any private 182,658 5.4 4,925 9,675 94,781 2.7 85.7 2.9 *2.6 *6.1
Public only 28,622 12.4 3,761 8,729 31,068 *1.6 *0.0 28.8 61.1 8.4
Uninsured 32,344 3.5 3,426 *9,603 *10,760 *8.0 *0.0 *0.0 *0.0 92
Age 65 and over:
Medicare only 11,515 17.4 7,263 12,962 25,926 *1.8 *0.0 85.2 *0.0 13
Medicare and private 19,570 18.8 10,370 15,018 55,122 1.1 22.7 70.7 *0.0 *5.5
Medicare and other public 3,568 25.9 — — — — — — — —
Poverty statuse
Poor 32,053 11.3 4,377 10,956 39,565 2.4 *12.9 34.8 34.5 15.4
Near-poor 12,196 9.8 4,370 8,631 10,311 *1.9 9.2 54.7 *23.1 *11.1
Low income 37,059 10.1 4,590 9,820 36,720 2.7 28.2 50.1 9.3 *9.7
Middle income 90,343 7.2 5,630 10,821 70,036 2.2 48.4 34.4 3.4 11.6
High income 106,754 5.7 6,477 12,120 73,597 1.9 58.9 28.1 *1.2 *10.0
Metropolitan statistical area (MSA)
MSA 226,861 7.2 $5,349 $11,234 $184,037 2.2 39.7 35.4 10.5 12.3
Non-MSA 51,545 9.1 4,678 9,814 46,192 2.4 44.5 37.6 7.4 8
Census region
Northeast 52,636 7.3 5,430 11,147 42,993 2.4 39.9 38.8 12.5 *6.4
Midwest 64,536 8.1 5,548 11,757 61,606 1.3 35.3 37.3 *11.0 *15.1
South 97,373 8.3 5,039 11,000 88,487 2.5 41.1 36.2 8 12.2
West 63,861 6.2 4,680 9,407 37,143 2.6 49.7 29.1 9.4 9.3
Perceived health status
Excellent 87,890 3.7 4,185 6,667 21,726 6.4 59.3 17.3 9.8 *7.3
Very good 93,499 5.3 4,680 7,818 38,559 3.3 55 26.2 8.8 *6.7
Good 67,922 8.2 4,561 9,554 53,393 1.8 51.3 25.9 9.2 11.8
Fair 20,666 20.2 6,158 14,239 59,554 1.3 30.2 51.1 *9.4 *8.1
Poor 7,720 36.4 8,876 18,067 50,724 1.1 23.7 43.5 12.4 *19.4
aInpatient hospital and physician services, ambulatory physician and nonphysician services, prescribed medicines, home health services, dental services, and various other medical equipment and services that were purchased or rented during the year are included. Over-the-counter medications, alternative care services, and telephone contacts are excluded.

bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

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

Note: Restricted to civilian noninstitutionalized population. Percents may not add to 100 because of rounding.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table 4. Office-based medical provider servicesa?Median and mean expenses per person with expense and
distribution of expenses by source of payment: United States, 2000 Expense per person with an expense
--------------------------------------------------------------------------------
Percent distribution of total expenses
by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in thousands) Percent with expense Median Mean Total
expenses
(in
millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Total 278,406 68.8 $243 $657 $125,946 17.8 48.5 16.8 5.8 11.1

Age in years
Under 65 243,624 66.1 212 592 95,400 19.9 58.1 3.2 6.6 12.2
Under 6 24,126 78.5 160 299 5,654 17.2 59.5 *0.3 15.7 7.3
6-17 48,405 60.9 127 269 7,930 23.8 57.4 *0.1 12.9 5.8
18-44 109,021 60.6 222 600 39,611 20.9 56.9 1.9 6.9 13.4
45-64 62,072 75.2 335 904 42,206 18.5 59.2 5.5 3.9 12.9
65 and over 34,782 87.6 490 1,003 30,546 11.4 18.6 59 3.3 7.7
Sex
Male 135,882 61.9 207 614 51,693 *16.1 47.7 16.9 4.8 14.4
Female 142,524 75.4 278 691 74,253 19 49.1 16.6 6.5 8.8
Race/ethnicity
White and other 209,401 73.2 268 703 107,778 18.2 49.4 17.1 4.6 10.7
Black 35,049 56 150 511 10,026 12 39.7 18.6 13.5 16.2
Hispanic 33,955 55 165 436 8,142 19.4 47.2 9.9 12.4 11.1
Health insurance statusd
Under age 65:
Any private 182,658 70.7 226 620 80,104 20.3 69.2 1.2 0.7 8.6
Public only 28,622 68 163 526 10,238 5.2 *0.0 21.1 55.7 *18.0
Uninsured 32,344 38.8 137 404 5,058 42.9 *0.0 *0.0 *0.0 57.1
Age 65 and over:
Medicare only 11,515 85.6 393 783 7,720 11.3 *0.0 71.7 *0.0 17
Medicare and private 19,570 89 548 1,099 19,144 12.1 29.6 53.5 *0.2 4.5
Medicare and other public 3,568 87.8 442 1,174 3,676 8.2 *0.0 60.4 26.4 *5.0
Poverty statuse
Poor 32,053 61.2 182 555 10,893 10.5 18.9 22.8 33.9 13.9
Near-poor 12,196 62.4 207 549 4,174 13.1 21.5 33.1 20.5 11.9
Low income 37,059 64.3 225 641 15,258 15.9 30.1 32.4 9.8 11.9
Middle income 90,343 68.2 238 630 38,854 15.5 49.3 17 2.2 15.9
High income 106,754 73.9 270 719 56,767 21.7 60.6 10 0.7 7
Metropolitan statistical area (MSA)
MSA 226,861 68.4 $242 $650 $100,923 18.2 48.8 16.1 5.6 11.3
Non-MSA 51,545 70.5 246 688 25,023 16.3 47.3 19.3 6.7 10.5
Census region
Northeast 52,636 73.2 253 647 24,946 17.1 50.7 16.3 7 8.9
Midwest 64,536 71.8 240 651 30,162 18.6 46.3 18.7 4.8 11.7
South 97,373 66.8 237 610 39,710 20.2 46.2 17.1 5.3 11.3
West 63,861 65.2 246 747 31,128 14.6 51.9 14.8 6.4 12.2
Perceived health status
Excellent 87,890 61.1 174 438 23,514 24 56.4 6.8 4.1 8.7
Very good 93,499 68.8 225 574 36,923 20.3 52.6 10.8 3.6 12.6
Good 67,922 72.4 277 722 35,496 16.5 50.7 17 6 9.8
Fair 20,666 84.8 500 1,115 19,540 11.8 37.9 27.4 10 13
Poor 7,720 87.1 676 1,521 10,224 10.9 27.4 40.1 8.8 12.7

aInpatient hospital and physician services, ambulatory physician and nonphysician services, prescribed medicines, home health services, dental services, and various other medical equipment and services that were purchased or rented during the year are included. Over-the-counter medications, alternative care services, and telephone contacts are excluded.

bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

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

Note: Restricted to civilian noninstitutionalized population. Percents may not add to 100 because of rounding.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table 5. Hospital outpatient servicesa—Median and mean expenses per person with expense and distribution of expenses by source of payment: United States, 2000
Expense per person
with an expense
--------------------------------------------------------------------------------
Percent distribution of total expenses
by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in
thousands) Percent with expense Median Mean Total
expenses (in millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Total 278,406 13.1 $555 $1,501 $54,880 7.5 52.9 22.2 5 12.4

Age in years
Under 65 243,624 11 528 1,376 36,767 8.6 68 *5.3 6.3 11.8
Under 6 24,126 6.3 325 962 1,465 4.8 71.1 *1.6 *17.2 *5.3
6-17 48,405 5.3 353 1,175 3,012 6.8 64.8 *0.2 *17.5 10.8
18-44 109,021 9.7 535 1,364 14,431 10.3 65.2 *3.7 5.1 15.6
45-64 62,072 19.4 605 1,480 17,860 7.8 70.5 7.7 4.6 9.5
65 and over 34,782 28.3 615 1,841 18,113 5.4 22.2 56.5 *2.4 *13.5
Sex
Male 135,882 10.2 683 1,781 24,716 8 51.4 21.3 4.5 14.8
Female 142,524 15.9 462 1,329 30,163 7.2 54.1 22.9 5.4 10.4
Race/ethnicity
White and other 209,401 14.8 577 1,506 46,613 7.5 55 23.1 2.7 11.7
Black 35,049 8.9 383 1,468 4,558 *10.7 41.3 17.4 15.7 14.9
Hispanic 33,955 7.4 527 1,482 3,709 4.3 40.5 *16.8 21.1 17.3
Health insurance statusd
Under age 65:
Any private 182,658 12 570 1,391 30,505 8.6 81.9 1.2 1 7.4
Public only 28,622 11.1 337 1,364 4,330 *3.1 *0.0 36.7 46.9 13.3
Uninsured 32,344 5 *380 1,190 1,932 21.1 *0.0 *0.0 *0.0 78.9
Age 65 and over:
Medicare only 11,515 22.5 549 2,012 5,215 *2.9 *0.0 62.7 *0.0 *34.4
Medicare and private 19,570 32.5 704 1,824 11,613 5.3 34.7 54.8 *0.6 *4.7
Medicare and other public 3,568 24.5 — — — — — — — —
Poverty statuse
Poor 32,053 10 377 1,215 3,882 7.4 20.8 26.2 29.9 15.8
Near-poor 12,196 13.3 *295 *1,441 *2,334 *3.7 *9.8 58.5 *15.3 *12.6
Low income 37,059 12.7 585 1,654 7,785 7.6 37.5 30.3 8.6 16.1
Middle income 90,343 12.8 590 1,601 18,538 6.3 51.6 21.4 2.2 18.5
High income 106,754 14.5 581 1,444 22,340 9 69.3 15.5 *0.8 5.4
Metropolitan statistical area (MSA)
MSA 226,861 12.6 $563 $1,457 $41,592 7.6 53.4 20.8 4.8 13.4
Non-MSA 51,545 15.6 532 1,656 13,288 7.4 51.2 26.5 5.8 9.1
Census region
Northeast 52,636 16.4 528 1,325 11,415 3.7 55.1 29.1 4.4 *7.7
Midwest 64,536 16 482 1,594 16,504 8.1 51.5 22.6 2.5 *15.3
South 97,373 11.5 658 1,495 16,743 7.8 54.7 18.2 6 13.2
West 63,861 10 547 1,596 10,217 10.4 49.5 20.3 8.2 11.6
Perceived health status
Excellent 87,890 7.4 362 1,031 6,721 7 68.7 10.4 2.9 10.9
Very good 93,499 12.1 480 1,291 14,652 10.6 59.3 13.8 4.7 11.6
Good 67,922 16.1 600 1,500 16,430 5.3 52.4 21.3 5.5 *15.5
Fair 20,666 25.8 709 1,879 10,001 5.2 43.4 32.4 7.1 11.8
Poor 7,720 30.8 1,098 2,933 6,981 *9.9 38.8 38.8 3.6 9
aInpatient hospital and physician services, ambulatory physician and nonphysician services, prescribed medicines, home health services, dental services, and various other medical equipment and services that were purchased or rented during the year are included. Over-the-counter medications, alternative care services, and telephone contacts are excluded.

bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

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

Note: Restricted to civilian noninstitutionalized population. Percents may not add to 100 because of rounding.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table 6. Emergency room servicesa?Median and mean expenses per person with expenses and distribution of expenses by source of payment: United States, 2000
Expense per person
with an expense
--------------------------------------------------------------------------------
Percent distribution of total expenses
by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in
thousands) Percent with expense Median Mean Total
expenses (in millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Total 278,406 11.6 $315 $594 $19,248 12.2 46.1 17.9 8.4 15.3

Age in years
Under 65 243,624 10.9 312 557 14,781 14.6 55.1 3 10.4 16.9
Under 6 24,126 13.3 245 454 1,461 12 57.2 *0.4 22.9 *7.5
6-17 48,405 9.8 253 425 2,019 9.2 53.2 *0.4 15.1 *22.1
18-44 109,021 10.9 348 582 6,894 17.5 53.6 *1.2 10.4 17.3
45-64 62,072 10.8 383 654 4,407 13.3 57.7 7.8 4 17.2
65 and over 34,782 16.8 341 764 4,467 4.6 16.4 67.3 2.1 *9.7
Sex
Male 135,882 10.9 306 618 9,193 12.1 43.1 15.3 7 22.5
Female 142,524 12.3 328 574 10,056 12.4 48.9 20.3 9.8 8.6
Race/ethnicity
White and other 209,401 11.7 333 602 14,777 12 48.5 18.8 6.5 14.1
Black 35,049 13 296 575 2,608 9.4 37.4 16.5 13 23.7
Hispanic 33,955 9.7 260 566 1,863 18 39.6 *12.7 17.3 12.3
Health insurance statusd
Under age 65:
Any private 182,658 10.4 336 574 10,956 11.7 74.4 0.9 *2.4 10.7
Public only 28,622 17.7 218 432 2,185 5.5 *0.0 16 58 20.5
Uninsured 32,344 7.4 349 681 1,640 45.8 *0.0 *0.0 *0.0 54.2
Age 65 and over:
Medicare only 11,515 15.2 349 815 1,423 5.6 *0.0 75.2 *0.0 *19.2
Medicare and private 19,570 16.2 328 733 2,329 5 31.4 60 *0.5 *3.1
Medicare and other public 3,568 25.6 — — — — — — — —
Poverty statuse
Poor 32,053 14.8 245 566 2,686 9.7 *15.0 21.2 32 22.1
Near-poor 12,196 14.4 320 568 999 *8.3 24.8 30.5 15.8 *20.5
Low income 37,059 14.1 301 642 3,356 15.7 26.6 23.1 8.3 26.2
Middle income 90,343 11.8 349 594 6,351 13.9 50 19.1 3.3 13.7
High income 106,754 9.3 344 588 5,856 10.3 71 10 *2.1 6.6
Metropolitan statistical area (MSA)
MSA 226,861 11.3 $318 $613 $15,695 11.7 47.3 17.9 8 15.1
Non-MSA 51,545 13.2 300 523 3,553 14.7 41 18.1 10.3 16
Census region
Northeast 52,636 12.2 285 504 3,246 9.5 47.6 21.2 9.7 12
Midwest 64,536 12.7 361 710 5,816 10 45.7 16.7 9 *18.6
South 97,373 11.9 301 562 6,519 16.4 43.8 17.1 7.3 15.4
West 63,861 9.7 317 595 3,668 10.8 49.7 18.5 8.5 12.5
Perceived health status
Excellent 87,890 8.9 290 526 4,123 11.3 58.8 4.2 9.1 16.5
Very good 93,499 9.5 300 588 5,222 13.3 50 7.9 7.3 21.4
Good 67,922 12.6 349 586 4,997 13.9 48.5 19.5 8.4 9.7
Fair 20,666 20.7 341 656 2,806 11.1 34 38.1 8.5 8.3
Poor 7,720 34.4 373 733 1,945 9.3 23 39.4 10.6 17.8
aExpenses for visits to medical providers seen in emergency rooms (except visits resulting in an overnight hospital stay) are included. excluded.
bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

ePoor—persons in families with income less than 100 percent of the poverty line, including those whose losses exceeded their earnings, resulting in negative income; nearpoor— persons in families with income from 100 percent to less than 125 percent of the poverty line; low income—persons in families with income from 125 percent to less than 200 percent of the poverty line; middle income—persons in families with income from 200 percent to less than 400 percent of the poverty line; high income—persons in families with income at or over 400 percent of the poverty line. —Less than 100 sample cases.

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

Note: Restricted to civilian noninstitutionalized population. Percents may not add to 100 because of rounding.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table 7. Prescription medicinesa?Median and mean expenses per person with expense and distribution of expenses by source of payment: United States, 2000
Expense per person
with an expense
--------------------------------------------------------------------------------
Percent distribution of total expenses
by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in
thousands) Percent with expense Median Mean Total
expenses (in millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Total 278,406 62.3 $186 $594 $102,992 46.1 33.9 4.6 11.2 4.2

Age in years
Under 65 243,624 58.5 136 485 69,171 41 42.4 0.9 12.9 2.8
Under 6 24,126 56.9 32 86 1,174 42.9 34 *0.1 21.7 *1.2
6-17 48,405 46.2 61 213 4,752 32.9 47 *0.1 17.7 *2.4
18-44 109,021 56 121 382 23,297 39.6 43 *0.3 15.8 1.2
45-64 62,072 73.3 434 878 39,948 42.8 41.7 *1.4 10.4 3.9
65 and over 34,782 88.3 695 1,102 33,821 56.6 16.6 12.1 7.7 7
Sex
Male 135,882 54.9 146 546 40,780 41 35 4.4 10.7 9
Female 142,524 69.2 219 631 62,212 49.5 33.2 4.7 11.5 1.1
Race/ethnicity
White and other 209,401 66.6 214 626 87,381 46.6 36 4.5 8.9 4.1
Black 35,049 50.8 125 487 8,657 44.2 22.4 4.6 22.3 6.5
Hispanic 33,955 47.2 92 434 6,954 42.4 22.4 5.4 26.5 3.2
Health insurance statusd
Under age 65:
Any private 182,658 61.7 144 445 50,128 38.4 58.5 *0.4 *1.4 1.5
Public only 28,622 62.1 119 810 14,396 35.7 *0.0 *3.1 57.1 4.1
Uninsured 32,344 37.6 89 382 4,647 86.3 *0.0 *0.0 *0.0 13.7
Age 65 and over:
Medicare only 11,515 87.6 627 1,041 10,504 69.4 *0.0 17.9 *0.0 12.7
Medicare and private 19,570 88.8 708 1,059 18,410 54 30.5 10.1 *0.7 4.7
Medicare and other public 3,568 89 934 1,541 4,895 38.6 *0.0 6.9 50.6 *3.9
Poverty statuse
Poor 32,053 58.6 139 691 12,984 44.5 9.2 4.1 38.8 3.4
Near-poor 12,196 60.2 213 749 5,496 55.6 8 *5.0 27.4 4
Low income 37,059 59.6 181 685 15,148 51.3 20.2 5.3 16.5 6.8
Middle income 90,343 61.9 176 569 31,787 47.4 35.7 5.9 6.6 4.4
High income 106,754 64.8 205 543 37,578 42.2 50.3 3.2 *1.0 3.3
Metropolitan statistical area (MSA)
MSA 226,861 61.1 $174 $576 $79,881 45 35.1 5.2 10.9 3.8
Non-MSA 51,545 67.1 239 668 23,111 50.1 29.9 2.5 12.1 5.5
Census region
Northeast 52,636 64.3 172 605 20,470 44.3 35.2 6.4 11 3.1
Midwest 64,536 64.1 204 622 25,745 46.1 38 3.6 8.8 3.6
South 97,373 62.6 223 622 37,963 49 33 2.2 11.4 4.3
West 63,861 58.1 135 507 18,814 42.3 28.8 8.6 14.1 6.1
Perceived health status
Excellent 87,890 49 80 251 10,810 43.8 43.8 2.7 *7.4 2.2
Very good 93,499 61.6 150 422 24,345 44.9 41.6 4.2 6 3.3
Good 67,922 69.7 282 676 32,007 45.9 37.1 4.2 8.2 4.5
Fair 20,666 86.9 692 1,275 22,892 47.3 26.3 5.7 17.2 3.5
Poor 7,720 92.2 1,230 1,805 12,842 48.7 16.7 5.5 20.9 8.2
aExpenses for all prescribed medicines initially purchased or otherwise obtained during the year, as well as any refills, are included. Free samples are included in the estimate of percent of persons with any expense.
bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

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

Note: Restricted to civilian noninstitutionalized population. Percents may not add to 100 because of rounding.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table 8. Dental servicesa?Median and mean expenses per person with expense and distribution of expensed by source of payment: United States, 2000
Expense per person
with an expense
--------------------------------------------------------------------------------
Percent distribution of total expenses
by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in
thousands) Percent with expense Median Mean Total
expenses (in millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Total 278,406 40.1 $168 $498 $55,551 49.3 42.2 0.5 4 3.9

Age in years
Under 65 243,624 40.2 164 492 48,209 45.2 46.3 *0.0 4.6 3.9
Under 6 24,126 20.1 99 193 937 25.4 43.3 *0.0 25.6 *5.7
6-17 48,405 51.1 155 654 16,172 44 47.6 *0.0 6.5 1.9
18-44 109,021 36.8 155 404 16,223 42 49.1 *0.0 *4.6 4.3
45-64 62,072 45.4 209 528 14,876 51.2 42 *0.0 1.1 5.6
65 and over 34,782 39.5 196 534 7,341 76.7 15.2 3.6 0.4 4.1
Sex
Male 135,882 36.9 162 464 23,274 49.8 40.3 *0.4 *4.6 4.9
Female 142,524 43.2 172 525 32,277 49 43.6 *0.5 3.6 3.3
Race/ethnicity
White and other 209,401 45 178 524 49,390 49.8 42.3 0.5 3.6 3.8
Black 35,049 26 107 354 3,224 40.3 47.4 *0.3 7.1 4.9
Hispanic 33,955 24.4 128 354 2,936 51.7 35.3 *0.6 7.3 5.1
Health insurance statusd
Under age 65:
Any private 182,658 46.1 174 515 43,411 44.1 51.4 *0.0 *1.6 2.8
Public only 28,622 27.9 87 287 2,290 26.9 *0.0 *0.4 66.4 6.2
Uninsured 32,344 17.5 151 444 2,508 79.8 *0.0 *0.0 *0.0 20.3
Age 65 and over:
Medicare only 11,515 32.6 195 661 2,480 86.8 *0.0 *5.3 *0.0 *8.0
Medicare and private 19,570 47.9 200 490 4,601 72.6 24.3 1.6 *0.0 1.5
Medicare and other public 3,568 16.4 — — — — — — — —
Poverty statuse
Poor 32,053 24.8 105 345 2,744 44.1 23.3 *2.2 22.2 *8.2
Near-poor 12,196 25.4 150 495 *1,533 *31.0 *25.1 *0.3 *36.8 *6.8
Low income 37,059 28.6 144 392 4,157 59.5 25.1 *0.5 10.5 *4.5
Middle income 90,343 38.6 166 490 17,093 51.1 40.5 *0.6 *3.3 4.5
High income 106,754 51.6 185 545 30,025 48.3 48.2 0.3 *0.2 3
Metropolitan statistical area (MSA)
MSA 226,861 40.9 $170 $502 $46,597 48.1 42.9 0.6 4.4 4.1
Non-MSA 51,545 36.5 151 476 8,954 56 38.7 *0.1 2.2 3.1
Census region
Northeast 52,636 45.7 185 519 12,469 51.6 39.5 *0.7 3.9 4.3
Midwest 64,536 45 149 449 13,024 46.7 45.7 *0.3 *3.3 4
South 97,373 35.4 154 472 16,278 54.1 40.3 *0.4 1.3 3.9
West 63,861 37.8 200 571 13,780 44.2 43.6 *0.7 *8.0 3.5
Perceived health status
Excellent 87,890 42.6 160 477 17,845 45.7 48.3 *0.1 3 2.8
Very good 93,499 42.8 165 514 20,587 49.2 44.8 *0.5 1.9 3.6
Good 67,922 37.5 176 480 12,235 50.6 35.1 *0.7 *8.4 5.2
Fair 20,666 32.3 200 560 3,740 62.3 26.7 *0.6 3.8 6.7
Poor 7,720 26.4 185 561 1,144 53.2 26.9 *2.6 *12.6 *4.7
aServices provided by general dentists, dental hygienists, dental technicians, dental surgeons, orthodontists, endodontists, and periodontists are included.
bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

ePoor—persons in families with income less than 100 percent of the poverty line, including those whose losses exceeded their earnings, resulting in negative income; near poor—persons in families with income from 100 percent to less than 125 percent of the poverty line; low income—persons in families with income from 125 percent to less than 200 percent of the poverty line; middle income—persons in families with income from 200 percent to less than 400 percent of the poverty line; high income—persons in families with income at or over 400 percent of the poverty line.

—Less than 100 sample cases.

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

Note: Restricted to civilian noninstitutionalized population. Percents may not add to 100 because of rounding.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table 9. Home health servicesa?Median and mean expenses per person with expense and distribution of expensed by source of payment: United States, 2000
Expense per person
with an expense
--------------------------------------------------------------------------------
Percent distribution of total expenses
by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in
thousands) Percent with expense Median Mean Total
expenses (in millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Total 278,406 1.8 $1,710 $5,136 $25,640 12.4 *4.2 25.6 48.2 *9.6

Age in years
Under 65 243,624 0.8 1,507 6,551 12,960 *3.7 *3.6 *13.2 68 *11.5
Under 6 24,126 1.2 — — — — — — — —
6-17 48,405 *0.5 — — — — — — — —
18-44 109,021 0.5 — — — — — — — —
45-64 62,072 1.4 — — — — — — — —
65 and over 34,782 8.7 1,800 4,207 12,680 21.2 *4.7 38.4 28.1 7.6
Sex
Male 135,882 1.5 1,592 4,081 8,320 *13.0 *5.1 37.8 36 8
Female 142,524 2.1 1,775 5,863 17,321 *12.1 *3.7 19.8 54.1 *10.4
Race/ethnicity
White and other 209,401 1.9 1,500 4,831 19,552 15.7 *4.6 23.9 45.3 *10.4
Black 35,049 1.7 — — — — — — — —
Hispanic 33,955 1 — — — — — — — —
Health insurance statusd
Under age 65:
Any private 182,658 0.5 — — — — — — — —
Public only 28,622 3.7 — — — — — — — —
Uninsured 32,344 *0.2 — — — — — — — —
Age 65 and over:
Medicare only 11,515 7.6 — — — — — — — —
Medicare and private 19,570 6.9 1,290 3,289 4,436 *32.7 *13.5 42.6 *7.8 *3.5
Medicare and other public 3,568 22.2 — — — — — — — —
Poverty statuse
Poor 32,053 3.1 1,775 4,743 4,762 *16.0 *1.7 41.1 33.4 *7.9
Near-poor 12,196 3.7 — — — — — — — —
Low income 37,059 2.7 — — — — — — — —
Middle income 90,343 1.6 1,524 3,252 4,695 *8.6 *4.5 *24.4 *35.8 *26.7
High income 106,754 1 — — — — — — — —
Metropolitan statistical area (MSA)
MSA 226,861 1.7 $1,540 $4,917 $19,219 *13.1 *4.8 21.8 49.2 *11.2
Non-MSA 51,545 2.1 1,867 5,924 6,422 10.2 2.3 37.3 45.4 4.8
Census region
Northeast 52,636 2.2 — — — — — — — —
Midwest 64,536 1.9 — — — — — — — —
South 97,373 1.7 1,733 4,939 *8,118 *14.0 *4.9 *27.6 *49.2 *4.2
West 63,861 1.5 — — — — — — — —
Perceived health status
Excellent 87,890 0.5 — — — — — — — —
Very good 93,499 0.7 — — — — — — — —
Good 67,922 1.7 — — — — — — — —
Fair 20,666 6.8 1,602 *6,280 *8,810 *10.5 *2.1 *21.0 60 *6.3
Poor 7,720 16.3 1,775 4,309 5,412 *10.0 *9.0 45.6 32 *3.5
aExpenses for care provided by home health agencies and independent home health providers are included. Most home health expenses (87.5 percent) were for agency providers.
bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

—Less than 100 sample cases.

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

Note: Restricted to civilian noninstitutionalized population. Percents may not add to 100 because of rounding.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table 10. Other medical equipment and servicesa ?Median and mean expenses per person with expense and distribution of expensed by source of payment: United States, 2000
Expense per person
with an expense
--------------------------------------------------------------------------------
Percent distribution of total expenses
by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in
thousands) Percent with expense Median Mean Total
expenses (in millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Total 278,406 18.6 $180 $260 $13,412 71.3 16 3 6.7 3

Age in years
Under 65 243,624 17.4 178 237 10,037 71.1 18.6 *0.5 7.4 2.3
Under 6 24,126 2.4 — — — — — — — —
6-17 48,405 13.2 150 182 1,166 63.5 18.4 *0.1 16.7 *1.3
18-44 109,021 17.9 160 209 4,072 72.5 17.7 *0.1 6.9 2.7
45-64 62,072 25.7 223 292 4,653 72 19.3 *1.0 5.6 2.2
65 and over 34,782 26.7 200 364 3,375 71.6 8.1 10.3 4.7 5.3
Sex
Male 135,882 15.7 179 271 5,787 70.2 15.8 *2.9 6.3 4.9
Female 142,524 21.2 182 252 7,625 72.1 16.1 3.1 7.1 1.7
Race/ethnicity
White and other 209,401 20.6 187 264 11,406 72.8 16 3 5.1 3
Black 35,049 12.9 136 214 965 67.6 11.2 3.6 13.9 3.6
Hispanic 33,955 11.8 175 260 1,041 57.2 20.2 1.6 *18.3 *2.7
Health insurance statusd
Under age 65:
Any private 182,658 19.2 180 236 8,268 74.7 22.6 *0.1 *1.2 1.4
Public only 28,622 14.7 147 245 1,027 30.9 *0.0 *4.2 63 *1.8
Uninsured 32,344 9.8 160 233 742 87.4 *0.0 *0.0 *0.0 12.6
Age 65 and over:
Medicare only 11,515 24.8 180 323 923 69 *0.0 21.1 *0.0 9.9
Medicare and private 19,570 28.4 215 388 2,156 77.5 12.7 5.9 *0.1 *3.8
Medicare and other public 3,568 24 176 343 293 36.4 *0.0 *9.2 52.6 *1.7
Poverty statuse
Poor 32,053 14 150 251 1,124 52.4 4.8 *3.7 33.6 *5.5
Near-poor 12,196 14.8 156 245 442 55.4 *12.1 *8.2 *22.4 *2.0
Low income 37,059 16.3 165 255 1,536 72.5 8.6 6.3 9.1 3.5
Middle income 90,343 16.5 168 239 3,555 70.4 16.3 *3.6 *5.0 *4.7
High income 106,754 22.9 200 276 6,755 75.6 19.6 1.4 *1.6 1.7
Metropolitan statistical area (MSA)
MSA 226,861 18.5 $182 $261 $10,973 71.5 16 2.2 7.1 3.2
Non-MSA 51,545 18.6 173 254 2,439 70.3 15.9 *6.3 5.1 2.4
Census region
Northeast 52,636 19.7 200 258 2,678 72.3 17.2 *3.1 5 2.3
Midwest 64,536 20.3 180 267 3,504 76 15.5 1.4 3.3 3.8
South 97,373 17.6 174 256 4,389 72.3 11.8 *3.9 *9.0 *3.0
West 63,861 17.2 180 258 2,842 62.8 21.9 *3.3 9.1 2.9
Perceived health status
Excellent 87,890 15.1 175 243 3,220 77.9 17 *1.5 2.2 1.5
Very good 93,499 19 185 239 4,236 73.3 18.7 *1.3 *4.0 *2.8
Good 67,922 19.4 180 258 3,411 69.7 14.7 *4.9 7.7 2.9
Fair 20,666 24.1 190 323 1,613 70.9 12 5 8.1 4
Poor 7,720 31.9 181 379 933 45.2 12.1 5.1 29.1 *8.4
aExpenses for eyeglasses, contact lenses, ambulance services, orthopedic items, hearing devices, prostheses, bathroom aids, medical equipment, disposable supplies, alterations/modifications, and other miscellaneous items or services that were obtained, purchased, or rented during the year are included. About two-thirds of the expenditures in this category were for vision items.
bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

ePoor—persons in families with income less than 100 percent of the poverty line, including those whose losses exceeded their earnings, resulting in negative income; near poor— persons in families with income from 100 percent to less than 125 percent of the poverty line; low income—persons in families with income from 125 percent to less than 200 percent of the poverty line; middle income—persons in families with income from 200 percent to less than 400 percent of the poverty line; high income—persons in families with income at or over 400 percent of the poverty line.

—Less than 100 sample cases.

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

Note: Restricted to civilian noninstitutionalized population. Percents may not add to 100 because of rounding.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Technical Appendix

The data source for this report is the Medical Expenditure Panel Survey (MEPS), an ongoing annual survey of the civilian noninstitutionalized population that collects detailed information on health care use and expenditures (including sources of payment), health insurance, health status, access, and quality. MEPS also collects detailed demographic and economic information on the people in the households surveyed. Expenditure data in MEPS are obtained from both the household interview and the Medical Provider Component, which collects data from a sample of respondents’ hospitals, physicians, home health care providers, and pharmacies. (See the section “MEPS Expenditures Methodology” in this appendix for more details.)

The expenditure estimates for 2000 and 1996 presented and cited in this report were obtained from the compendia of tables available on the MEPS Web site: http://www.meps.ahrq.gov/data_public.htm. However, the 2000 estimates by place of residence (MSA and non-MSA) presented here differ slightly from those on the Web site. These published estimates were based on complete information for all persons, whereas those on the Web site classified a small proportion of persons with missing MSA status.

More information about MEPS can be found at http://www.meps.ahrq.gov. Detailed descriptions of the survey and its methodology have been previously published (Cohen JW, 1997; Cohen SB, 2000; Cohen SB, 2003).

Definitions

Expenditures. Expenditures in this report refer to what is actually paid for health care services. More specifically, in MEPS, expenditures are defined as the sum of direct payments for care received, including out-of-pocket payments for care received and payments made by private insurance, Medicare, Medicaid, and other sources. Payments for over-the-counter drugs and alternative care services are not included in MEPS total expenditures. Indirect payments not related to specific medical events, such as Medicaid Disproportionate Share and Medicare Direct Medical Education subsidies, are also not included.

This definition of expenditures differs somewhat from that used in predecessor surveys, the 1987 National Medical Expenditure Survey and the 1977 National Medical Care Expenditure Survey, in which charges rather than payments were used to measure medical expenditures. Users who wish to compare the expenditure data presented in this report with data from the 1987 survey should consult Zuvekas and Cohen (2002).

Type of service. In addition to expenditures for total health services (Table 2), expenses are classified in this report into eight broad types of service: hospital inpatient, office-based medical provider services, hospital outpatient, emergency room, prescription medicines, dental services, home health, and other medical equipment and services. These categories are described below and, where relevant, in the footnotes to the tables in this report.

• Hospital inpatient services (Table 3). 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 emergency room expenses incurred immediately prior to inpatient stays. Expenses for reported hospital stays with the same admission and discharge dates are also included. Expenses for newborns who left the hospital on the same day as the mother are included in the mother’s record.

• Office-based medical provider services (Table 4). This category includes expenses for visits to medical providers seen in office-based settings or clinics.

• Hospital outpatient services (Table 5). This category includes expenses for visits to both physicians and other medical providers seen in hospital outpatient departments, including payments for services covered under the basic facility charge and those for separately billed physician services.

• Emergency room services (Table 6). This category includes expenses for visits to medical providers seen in emergency rooms (except visits resulting in a hospital admission). These expenses include payments for services covered under the basic facility charge and those for separately billed physician services.

• Prescription medicines (Table 7). This category includes expenses for all prescribed medications initially purchased or otherwise obtained during 2000, as well as any refills.

• Dental services (Table 8). 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 (Table 9). This category includes expenses for care provided by home health agencies and independent home health providers.

• Other medical equipment and services (Table 10). This category includes expenses for eyeglasses, contact lenses, ambulance services, orthopedic items, hearing devices, prostheses, bathroom aids, medical equipment, disposable supplies, alterations/modifications, and other miscellaneous items or services that were obtained, purchased, or rented during the year. About two-thirds of the expenditures in this category were for vision items.

Sources of payment. Estimates of sources of payment presented in this report represent the percentage of the total sum of expenditures paid for by each source. Sources of payment are classified as follows:

• Out of pocket by user or family.

• Private insurance-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 TRICARE (Armed-Forces-related coverage) are also included. Payments from plans that provide coverage for a single service only, such as dental or vision coverage, are not included.

• Medicare-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-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.

• Other-Includes payments from the Department of Veterans Affairs (except TRICARE); 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); Workers’ Compensation; various unclassified sources (e.g., automobile, homeowner’s, or other liability insurance, and other miscellaneous or unknown sources); Medicaid payments reported for persons who were not reported as enrolled in the Medicaid program at any time during the year; and private insurance payments reported for persons without any reported private health insurance coverage during the year.

Age. The respondent was asked to report the age of each family member as of the date of each interview. In this report, age is based on the sampled person’s age as of December 31st of the reported year. If data were not collected at the end of the year because the sample person was out of scope (e.g., deceased or institutionalized), then age at the time of the last inscope interview(s) was used.

Race/ethnicity. Classifications by race/ethnicity in this report are based on the following three race/ethnicity groups: white/other, black, and Hispanic. Classification by race and ethnicity is based in information reported in MEPS for each family member. First, respondents were asked if the sample person’s main national origin or ancestry was Puerto Rican; Cuban; Mexican, Mexican American, or Chicano; other Latin American; or other Spanish. All persons whose main national origin or ancestry was reported as one of these Hispanic groups, regardless of racial background, are classified as Hispanic. The second category is comprised of people who were not classified as Hispanic but whose race was reported as black. All other persons were classified as white/other. In this group, only about 5 percent were reported as a race other than white (e.g., American Indians, Aleutian Islanders and Eskimos, Asian and Pacific Islanders, and unspecified races).

Health insurance status. Individuals under age 65 were classified into the following three insurance categories based on household responses to health insurance status questions administered during Rounds 1-3 of the MEPS Household Component.

• Any private health insurance-Individuals who, at any time during the year, had insurance that provides coverage for hospital and physician care (other than Medicare, Medicaid, or other public hospital/physician coverage) are classified as having private insurance. Coverage by TRICARE (Armed-Forces-related coverage) is also included as private health 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 people not covered by Medicare, TRICARE, Medicaid, other public hospital/physician programs, or private hospital/physician insurance at any time during the entire year or period of eligibility for the survey. 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.

• Medicare and other public.

Income. Each year persons were classified according to their family’s income. In this report, income is expressed in terms of poverty status, the ratio of the family’s income to the Federal poverty thresholds, which control for the size of the family and the age of the head of the family. In this report, the following classification was used.

• Poor-Persons in families with income less than 100 percent of the poverty line, including those whose losses exceeded their earnings, resulting in negative income.

• Near-poor-Persons in families with income from 100 percent to less than 125 percent of the poverty line.

• Low income-Persons in families with income from 125 percent to less than 200 percent of the poverty line.

• Middle income-Persons in families with income from 200 percent to less than 400 percent of the poverty line.

• High income-Persons in families with income at or over 400 percent of the poverty line.

In MEPS, personal income from each household member was summed to create family income. Potential income sources asked about in the survey interview include annual earnings from wages, salaries, bonuses, tips, and commissions; business and farm gains and losses; unemployment and Workers’ Compensation payments; interests and dividends; alimony, child support, and other private cash transfers; private pensions; individual retirement account (IRA) withdrawals; Social Security and Department of Veterans Affairs payments; Supplemental Security Income and cash welfare payments from public assistance; TANF (Temporary Assistance for Needy Families, formerly known as Aid to Families with Dependent Children or AFDC); gains or losses from estates, trusts, partnerships, C corporations, rent, and royalties; and a small amount of other income.

Perceived health status. In every round of MEPS, the respondent was asked to rate the health of every member of the family. The exact wording of the question is as follows: “In general, compared to other people of (PERSON)’s age, would you say that (PERSON)’s health is excellent, very good, good, fair, or poor?” In the tables, this variable usually reflects responses to the last interview for the calendar year (Round 3 or Round 5). However, if no response was obtained from that interview, then reported health status was based on the most recent of the prior two interviews. A small proportion of persons had no valid response for health status on any of the three interviews.

Place of residence. Each MEPS sample person was classified as residing either inside or outside a metropolitan statistical area (MSA) as designated by the U.S. Office of Management and Budget, which applied 1990 standards using population counts from the 1990 U.S. census. An MSA is a large population nucleus combined with adjacent communities that have a high degree of economic and social integration with the nucleus. Each MSA has one or more central counties containing the area’s main population concentration. In New England, metropolitan areas consist of cities and towns rather than whole counties. MSA data are based on MSA status as of the end of the reference year. If MSA status as of December 31 was not known, then MSA status at the time of the previous interview was used.

Region of residence. Each MEPS sample person was classified as living in one of the following four regions as defined by the U.S. Census Bureau.

• Northeast-Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, and Pennsylvania.

• Midwest-Ohio, Indiana, Illinois, Michigan, Wisconsin, Minnesota, Iowa, Missouri, North Dakota, South Dakota, Nebraska, and Kansas.

• South-Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi, Arkansas, Louisiana, Oklahoma, and Texas.

• West-Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, Washington, Oregon, California, Alaska, and Hawaii.

Sample Design

Each year, the MEPS Household Component (HC) sample is drawn from those households that completed the prior year’s National Health Interview Survey (NHIS). For example, households selected for participation in MEPS Panel 5 (beginning in 2000) completed interviews in the 1999 NHIS, the sample for MEPS Panel 4 (beginning in 1999) was drawn from the 1998 NHIS, and so on. Because NHIS is used as a sampling frame, the MEPS design is not only nationally representative of the civilian noninstitutionalized population, but also includes an oversampling of Hispanics and blacks. NHIS is conducted by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention.

MEPS collects data via an overlapping panel design. Each household completes five interviews (“rounds” of data collection) over a period of 21/2 years, providing data for two full calendar years. Data from Rounds 1, 2, and 3 provide information for the first year of estimation, and data from Rounds 3, 4, and 5 provide data for the second year of estimates. The estimates in this report for calendar year 2000 were based on data collected from Rounds 3, 4, and 5 of MEPS Panel 4 and Rounds 1, 2, and 3 of MEPS Panel 5. (Note that the reference period for Round 3 of a MEPS panel overlaps two calendar years.) In MEPS, a single respondent provides most of the information on the health care experience of the entire family via computer-assisted personal interviewing (CAPI).

The MEPS response rate reflects response to both MEPS and NHIS. The overall response rate for MEPS Panel 4 in 2000, including the NHIS response rate, was 63.7 percent. The overall response rate for Panel 5 in 2000, including the NHIS response rate, was 68.3 percent. The response rate for 2000 MEPS annual estimates after combining both panels was 65.8 percent.

Accuracy of Estimates

The estimates of total expenditures in each table are based on 23,839 sample persons. They were weighted to develop population estimates for a total of 278,405,516 persons who were in the U.S. civilian noninstitutionalized population for part or all of 2000. All expenditures for persons who were in the target population for the full year, from January 1 through December 31, 2000, 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.

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. Only statistically significant differences between estimates are discussed in the text. However, it should be noted that each individual significance test was conducted at the 0.05 level, which does not control the error rate for all significance tests conducted simultaneously at the 0.05 level.

The statistics presented in this report are affected by both sampling error and sources of nonsampling error, which include nonresponse bias, respondent reporting errors (response errors), interviewer effects, and data processing misspecifications. The nonsampling errors, such as response errors, are difficult to measure, but every effort is made to minimize such errors at each step of the MEPS operation. The sampling error, however, can be measured by the variance of the estimator. A Taylor-series approach in SUDAAN is used to produce appropriate standard errors for weighted estimates from MEPS with its complex survey design. Standard errors for the MEPS estimates in this report are shown in Tables A-J. The MEPS person-level estimation weights include nonresponse adjustments and poststratification adjustments to population estimates derived from the Current Population Survey based on cross-classifications by region, MSA status, age, race/ethnicity, and sex. For a detailed description of the MEPS survey design, sample design, estimation strategies, and methods used to minimize sources of nonsampling error, see JW Cohen (1997), SB Cohen (1997), and SB Cohen (2003).

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.

MEPS Expenditures Methodology

Expenditure estimates in this report are based on the sum of total payments for medical events in 2000 reported in the MEPS HC. The HC collected annual data on the use of and associated expenditures for office- and hospital-based care, emergency room services, home health care, dental services, prescription medicines, and vision aids and other medical equipment and services. In addition, the MEPS Medical Provider Component (MPC) collected expenditure data from a sample of medical and pharmaceutical providers that provided care and medicines to sample people in 2000. Expenditure data collected in the MPC are generally regarded as more accurate than comparable data collected in the HC and were used to improve the overall quality of MEPS expenditure data in this report. For a more detailed description of the MPC, see Machlin and Taylor (2000).

Expenditure data were imputed to replace missing data, provide estimates for care delivered under capitated reimbursement arrangements, and adjust household-reported insurance payments because respondents were often unaware that their insurer paid a discounted amount to the provider. This section contains a general description of the approaches used for these three situations. A more detailed description of the editing and imputation procedures is provided in the documentation for the MEPS event-level files, which are available through the AHRQ Web site at http://www.meps.ahrq.gov/. For more information on the approach used to impute missing expenditure data on prescription medicines, see Moeller, Stagnitti, Horan, et al. (2001).

Missing data on expenditures were imputed using a weighted sequential hot-deck procedure for most medical visits and services. In general, this procedure imputes data from events with complete information to events with missing information but similar characteristics. For each event type, selected predictor variables with known values (e.g., total charge; demographic characteristics; region; provider type; and characteristics of the event of care, such as whether it involved surgery) were used to form groups of donor events with known data on expenditures, as well as identical groups of recipient events with missing data. Within such groups, data were assigned from donors to recipients, taking into account the weights associated with the complex MEPS survey design. Only MPC data were used as donors for hospital-based events, while data from both the HC and MPC were used as donors for office-based physician visits.

Because payments for medical care provided under capitated reimbursement arrangements and through public clinics and Department of Veterans Affairs (VA) hospitals are not tied to particular medical events, expenditures for events covered under those types of arrangements and settings were also imputed. Events covered under capitated arrangements were imputed from events covered under managed care arrangements that were paid based on a discounted fee-for-service method, while imputations for visits to public clinics and VA hospitals were based on similar events that were paid on a fee-for-service basis. As for other events, selected predictor variables were used to form groups of donor and recipient events for the imputations.

An adjustment also was applied to some HC-reported expenditure data because an evaluation of matched HC/MPC data showed that respondents who reported that charges and payments were equal were often unaware that insurance payments for the care had been based on a discounted charge. To compensate for this systematic reporting error, a weighted sequential hot-deck imputation procedure was implemented to determine an adjustment factor for HC-reported insurance payments when charges and payments were reported to be equal. As for the other imputations, selected predictor variables were used to form groups of donor and recipient events for the imputation process.

In some situations, it was reported that one charge covered multiple contacts between a sample person and a medical provider (e.g., obstetrical services, orthodontia). In these situations, total payments for the fee (sometimes called a flat or global fee) were included if the initial service was provided in 2000. For example, all payments for an orthodontist’s fee that covered multiple visits over 3 years were included if the initial visit occurred in 2000. However, if a 2000 visit to an orthodontist was part of a flat fee for which the initial visit occurred in 1999, then none of the payments for the flat fee were included. Most of the expenditures for medical care reported by MEPS participants were associated with medical events that were not part of a flat-fee arrangement.

Sample respondents sometimes reported medical events for which no payments actually were made. This situation could occur for several reasons, including when free care or a free sample of medicine was provided, bad debt was incurred, no charge was made for a followup visit (e.g., after a surgical procedure), or care was covered under a flat-fee arrangement beginning in an earlier year. These types of events were treated as valid $0 payments when developing the estimates contained in this report.

Because of methodological differences, caution should be used when comparing the estimates in this report with data from other sources. National health care expenditures from MEPS, for example, are lower than the expenditures for personal health care typically cited from the National Health Accounts (NHA) of the Centers for Medicare & Medicaid Services. The primary reasons for the differences are that the NHA include a wider variety of expenses and also include expenses for people who are not part of the community population. A comparison of MEPS and NHA estimates for comparable expenditures and population has been previously published (Selden, Levit, Cohen, et al., 2001).

Table A. Standard errors for expenses by event type: United States, 2000
Corresponds to Table 1
Expenses
--------------------------------------------------------------------------------

Payments (in billions)
--------------------------------------------------------------------------------
Percent distribution
--------------------------------------------------------------------------------

Event Type All
Expenses Ambulatory
Expenses All
Expenses Ambulatory
Expenses
Standard Error

--------------------------------------------------------------------------------

Totala 31.1 NA NA NA
Hospital inpatientb 16.7 NA 1.4 NA
Ambulatoryc 10.2 NA 0.8 NA
Office-based visits NA 6.9 NA 1
Hospital outpatient visits NA 3.4 NA 1.1
Emergency room visits NA 1.3 NA 0.4
Prescription medicinesd 4.9 NA 0.5 NA
Dentale 2.9 NA 0.4 NA
Home healthf 3.8 NA 0.6 NA
Other medicalg 0.8 NA 0.1 NA
aTotal includes inpatient hospital and physician services, ambulatory physician and nonphysician services, prescribed medicines, home health services, dental services, and various other medical equipment, supplies, and services that were purchased or rented during the year. Over-the-counter medications, alternative care services, and telephone contacts are excluded.

bHospital admissions that did not involve an overnight stay are included. Expenses include room 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. Events for newborns who left the hospital on the same day as the mother are treated as separate events, but associated expenses are included in expense estimates.

dAll prescribed medicines initially purchased or otherwise obtained during 2000, as well as refills and free samples, are included.

eServices provided by general dentists, dental hygienists, dental technicians, dental surgeons, orthodontists, endodontists, and periodontists are included.

fExpenses for care provided by home health agencies and independent home health providers are included. Most home health expenses (87.5 percent) were for agency providers.

NA—Not applicable.

Table B. Standard errors for total health servicesa ?Median and mean expenses per person with expenses
and distribution of expenses by source of payment: United States, 2000
Corresponds to Table 2
Expense per person
with an expense
--------------------------------------------------------------------------------
Percent distribution
of total expenses by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in
thousands) Percent
with expense Median Mean Total
expenses (in
millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Standard Error

--------------------------------------------------------------------------------

Total † 0.4 18 78 31,076 0.5 1.3 1 0.8 1

Age in years
Under 65 † 0.5 15 70 25,977 0.6 1.4 0.8 1.1 1.3
Under 6 † 1 14 170 3,962 1.6 7.8 0.1 8 1.7
6-17 † 0.8 13 60 3,184 1.6 2.5 0 2.2 2
18-44 † 0.6 16 83 11,862 0.9 2 2 1.9 1.4
45-64 † 0.6 40 177 13,566 1 2.5 0.9 1 2.3
65 and over † 0.5 84 271 10,625 0.9 1.2 1.6 0.7 1
Sex
Male † 0.6 19 127 18,854 0.8 1.8 1.7 1.1 1.9
Female † 0.4 23 95 17,412 0.7 1.3 1 1 0.8
Race/ethnicity
White and other † 0.4 22 88 27,175 0.6 1.4 1.1 0.9 1.2
Black † 1.2 26 283 10,353 1.4 2.6 3.2 2.6 2.5
Hispanic † 1 19 107 4,373 1.2 2.7 2.2 1.9 0.9
Health insurance statusd
Under age 65:
Any private 8,688 0.5 17 67 19,664 0.6 1.1 0.3 0.3 0.8
Public only 1,863 1 40 279 8,155 1 0 4.1 3.8 1.4
Uninsured 1,710 1.2 17 271 5,310 7.2 0 0 0 7.2
Age 65 and over:
Medicare only 729 0.8 141 334 4,858 1.5 0 2.6 0 2.3
Medicare and private 971 0.6 107 368 8,668 1.2 2.1 2.2 0.3 1.2
Medicare and other public 280 1.2 421 855 3,866 1.4 0 4.3 3.3 1.9
Poverty statuse
Poor † 1.1 43 246 8,456 1.1 2.2 3.9 3.2 1.9
Near-poor † 1.9 65 273 3,081 1.8 1.5 4.5 4.7 1.6
Low income † 1 45 209 6,655 1.1 2.1 2.7 2.1 1.6
Middle income † 0.6 21 106 11,963 0.9 1.8 1.9 0.6 1.6
High income † 0.5 25 118 15,557 1 2.1 1.4 1 1.8
Metropolitan statistical area (MSA)
MSA † 0.5 20 85 28,346 0.6 1.4 1.2 0.8 1.2
Non-MSA † 0.7 44 197 12,959 1.2 2.9 2 1.6 0.9
Census region
Northeast † 0.9 35 140 11,555 1.2 2.5 2 1.6 1.1
Midwest † 0.8 53 167 13,592 1 2.8 2.9 1.5 3
South † 0.6 21 131 17,216 1 2.6 1.4 1.4 1.7
West † 0.9 36 133 15,525 0.9 2.4 2.2 1.8 0.9
Perceived health status
Excellent 3,445 0.6 14 55 5,436 1.3 2.1 1.2 1 0.8
Very good 4,684 0.6 22 71 9,030 0.9 1.9 1.6 0.7 1.3
Good 3,479 0.7 39 138 11,228 0.9 2 1.4 1.2 1.3
Fair 1,105 0.6 168 557 12,732 1.3 2.3 2.9 2.5 1.5
Poor 443 0.7 360 937 8,241 1.1 3.7 3.5 2.4 4.6
aInpatient hospital and physician services, ambulatory physician and nonphysician services, prescribed medicines, home health services, dental services, and various other medical equipment and services that were purchased or rented during the year are included. Over-the-counter medications, alternative care services, and telephone contacts are excluded.

bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

†Standard error approximately zero because of poststratification to Census Bureau population control tables.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table C. Standard errors for hospital inpatient servicesa ?Median and mean expenses per person with expenses and distribution of expenses by source of payment: United States, 2000
Corresponds to Table 3
Expense per person
with an expense
--------------------------------------------------------------------------------
Percent distribution of total
expenses by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in
thousands) Percent with expense Median Mean Total
expenses (in millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Total † 0.2 203 544 16,747 0.2 2.5 2.1 1.3 2.2

Age in years
Under 65 † 0.2 167 608 12,974 0.3 3.4 1.7 2.2 3.4
Under 6 † 0.6 659 2,012 2,730 1.7 11.5 0.1 8.8 3.5
6-17 † 0.3 — — — — — — — —
18-44 † 0.3 147 577 6,256 0.7 4.8 4.8 3.9 3.2
45-64 † 0.4 582 1,333 8,722 0.3 6.1 2.3 2.4 5.9
65 and over † 0.9 797 947 7,770 0.3 2.5 2.5 0.3 1.7
Sex
Male † 0.3 469 1,125 11,999 0.3 3.8 3.4 2.1 3.8
Female † 0.3 184 504 9,421 0.3 2.9 2.2 1.2 1.6
Race/ethnicity
White and other † 0.3 259 637 13,661 0.2 3 2.5 1.6 2.6
Black † 0.5 564 2,099 7,589 0.5 4.4 4.8 3.9 4.5
Hispanic † 0.4 381 834 2,315 1.2 5.7 5.1 3.2 1.6
Health insurance statusd
Under age 65:
Any private 8,688 0.2 266 660 9,204 0.4 2.4 0.8 1 2
Public only 1,863 0.8 278 1,180 5,036 0.6 0 7.3 6.8 2.2
Uninsured 1,710 0.4 721 3,824 4,498 3.7 0 0 0 3.7
Age 65 and over:
Medicare only 729 1.4 1,449 1,205 3,243 0.6 0 3.5 0 3.5
Medicare and private 971 1.1 949 1,505 6,533 0.3 4.2 3.8 0 2.1
Medicare and other public 280 3 — — — — — — — —
Poverty statuse
Poor † 0.7 366 1,261 5,969 0.6 3.9 6.4 5.5 3.4
Near-poor † 1.1 450 1,316 1,893 0.6 2.4 6.9 7.4 3.8
Low income † 0.6 304 917 4,191 0.6 4.3 5.1 2.1 3.1
Middle income † 0.3 362 856 7,141 0.4 4.2 3.9 0.8 3.1
High income † 0.3 444 1,117 9,271 0.4 5.5 4.2 0.5 5.4
Metropolitan statistical area (MSA)
MSA † 0.2 248 626 15,528 0.3 2.9 2.5 1.6 2.7
Non-MSA † 0.5 407 965 6,120 0.4 5 4 1.2 1.8
Census region
Northeast † 0.5 426 1,370 6,729 0.7 5.5 5.6 3.5 2.3
Midwest † 0.6 511 1,162 8,089 0.2 5.7 5.8 3.4 6.3
South † 0.3 262 754 10,423 0.4 4.7 3.1 1.6 3.2
West † 0.4 400 1,012 4,633 0.7 3.9 3.5 2.7 1.5
Perceived health status
Excellent 3,445 0.3 335 819 3,187 1.6 6.2 4.3 2.4 2.3
Very good 4,684 0.3 349 758 4,375 0.6 5.5 4.9 1.7 2.2
Good 3,479 0.4 330 783 5,769 0.4 3.9 2.9 2.3 3
Fair 1,105 1.1 768 1,752 9,778 0.2 4.3 4.2 3.2 2.6
Poor 443 2.1 1,212 2,269 7,013 0.3 6 6.3 3.5 7.4
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 newborns who left the hospital on the same day as the mother are included in the mother’s record.

bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

†Standard error approximately zero because of poststratification to Census Bureau population control tables.

—Less than 100 sample cases.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table D. Standard errors for office-based medical provider servicesa ?Median and mean expenses per person with expenses and distribution of expenses by source of payment: United States, 2000
Corresponds to Table 4
Expense per person
with an expense
--------------------------------------------------------------------------------
Percent distribution of
total expenses by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in thousands) Percent with expense Median Mean Total
expenses
(in
millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Standard Error

--------------------------------------------------------------------------------

Total † 0.5 5 16 6,871 0.6 1.3 0.9 0.4 0.9

Age in years
Under 65 † 0.6 5 17 5,936 0.8 1.4 0.5 0.5 1.1
Under 6 † 1.2 7 20 581 1.5 2.9 0.1 1.6 1.5
6-17 † 1.1 4 13 558 1.2 1.8 0 1.6 0.9
18-44 † 0.8 6 20 2,736 1.2 1.4 0.4 0.8 1.3
45-64 † 0.8 13 39 2,889 1.1 2.4 1.1 0.5 2.1
65 and over † 0.7 20 48 1,845 0.9 1 1.3 0.7 0.9
Sex
Male † 0.7 5 23 3,614 0.8 1.7 1.3 0.5 1.2
Female † 0.6 8 19 3,775 0.8 1.5 1.1 0.5 1.3
Race/ethnicity
White and other † 0.6 6 19 6,724 0.8 1.4 0.9 0.5 1
Black † 1.3 6 41 1,228 1.6 3.8 3.6 1.8 2.4
Hispanic † 1.2 7 27 847 1.6 2.1 1.6 1.3 1.1
Health insurance statusd
Under age 65:
Any private 8,688 0.6 6 20 5,191 0.9 1.2 0.3 0.1 0.8
Public only 1,863 1.4 8 45 1,125 0.8 0 3.3 4.8 6.6
Uninsured 1,710 1.2 7 39 586 3.8 0 0 0 3.8
Age 65 and over:
Medicare only 729 1.3 22 61 790 1.1 0 2.5 0 2.1
Medicare and private 971 0.9 32 64 1,408 1.3 1.4 1.6 0.1 1.1
Medicare and other public 280 2.1 51 233 829 2.3 0 2.1 2.6 1.9
Poverty statuse
Poor † 1.3 9 35 1,081 1 2.8 2.1 2.7 1.9
Near-poor † 2.2 19 47 455 1.8 3.5 4.1 3 2.1
Low income † 1.3 13 45 1,277 1 2.5 3.4 1.4 1.8
Middle income † 0.8 7 24 2,803 0.8 1.9 1.6 0.2 2.4
High income † 0.7 8 27 3,672 1.1 1.7 0.8 0.2 0.7
Metropolitan statistical area (MSA)
MSA † 0.6 6 17 6,372 0.7 1.4 1 0.4 1
Non-MSA † 1 9 43 2,733 1.3 3.2 2.3 0.9 1.7
Census region
Northeast † 1 9 33 2,001 1.1 2.4 1.4 1.2 1.5
Midwest † 1.2 11 28 2,489 1.3 2.4 1.9 0.9 2.8
South † 0.8 8 32 3,374 1 1.8 1.2 0.6 1.1
West † 1.3 12 27 4,954 1.2 3.3 2.5 0.7 1.5
Perceived health status
Excellent 3,445 0.9 5 20 1,699 1.5 1.8 0.8 0.6 1.2
Very good 4,684 0.8 8 22 2,644 1.1 2 0.9 0.4 2.4
Good 3,479 0.9 10 34 2,615 1 2.3 1.5 0.7 1
Fair 1,105 0.9 31 53 1,184 0.8 2.3 2.2 1.4 1.8
Poor 443 1.3 51 128 1,017 1.6 2.8 4.1 1.4 2.3
aExpenses for visits to medical providers seen in office-based settings are included.

bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

†Standard error approximately zero because of poststratification to Census Bureau population control tables.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table E. Standard errors for hospital outpatient servicesa ?Median and mean expenses per person with expenses and distribution of expenses by source of payment: United States, 2000
Corresponds to Table 5
Expense per person
with an expense
--------------------------------------------------------------------------------
Percent distribution of
total expenses by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in
thousands) Percent with expense Median Mean Total
expenses
(in millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Standard Error

--------------------------------------------------------------------------------

Total † 0.5 28 67 3,396 0.9 2.2 2.1 0.7 1.8

Age in years
Under 65 † 0.4 37 69 2,523 1.2 2.1 1.9 0.9 1.6
Under 6 † 0.6 91 164 311 1.2 6.9 1 5.6 2.2
6-17 † 0.4 73 173 523 1.8 6.9 0.2 5.7 2.8
18-44 † 0.5 56 132 1,610 2.4 2.7 2.3 0.9 3
45-64 † 0.9 55 92 1,377 1.2 3.2 2.2 1.2 1.4
65 and over † 1.3 61 181 1,985 1.2 2.5 3.4 0.9 4.5
Sex
Male † 0.5 48 143 2,411 1.6 3.6 2.5 1.1 3.5
Female † 0.6 31 60 1,940 0.9 2.4 2.6 0.7 1.6
Race/ethnicity
White and other † 0.6 31 72 3,166 1 2.5 2.4 0.4 2.1
Black † 0.8 78 223 815 4 7.3 3.9 4.6 3.5
Hispanic † 0.6 70 166 564 0.8 5.5 5.3 4.9 3.9
Health insurance statusd
Under age 65:
Any private 8,688 0.4 49 76 2,275 1.5 2 0.3 0.3 1.6
Public only 1,863 0.9 52 216 825 1.4 0 10.4 8.4 3.5
Uninsured 1,710 0.5 125 183 343 4.9 0 0 0 4.9
Age 65 and over:
Medicare only 729 2 83 481 1,358 1.3 0 10.4 0 10.9
Medicare and private 971 1.7 90 170 1,389 1.3 2.3 2.7 0.2 1.5
Medicare and other public 280 2.6 — — — — — — — —
Poverty statuse
Poor † 0.7 68 111 470 2 3.6 3.3 4.7 2.8
Near-poor † 1.5 126 445 792 2 4 14.3 7.8 5.4
Low income † 1 59 198 1,031 2.2 5.3 4.4 2.1 2.8
Middle income † 0.6 57 133 1,782 1.1 4.2 3.2 0.6 4.4
High income † 0.6 42 94 2,042 1.8 2.7 2.1 0.3 1.3
Metropolitan statistical area (MSA)
MSA † 0.5 33 77 2,888 1.1 2.4 1.9 0.7 2.3
Non-MSA † 0.9 54 133 1,785 0.9 5.2 6.5 1.7 2.4
Census region
Northeast † 1 51 110 1,343 0.5 4.6 6.6 0.8 2.7
Midwest † 1.1 39 147 2,023 1.6 4.8 3.4 0.5 4.8
South † 0.7 69 100 1,637 1.3 3.3 1.9 1.5 2.5
West † 0.7 78 194 1,731 3 4.6 5.1 2 1.9
Perceived health status
Excellent 3,445 0.4 46 80 645 1.2 3.9 2.3 0.8 2.3
Very good 4,684 0.6 39 82 1,182 1.9 3.4 2 1.2 2.4
Good 3,479 0.8 46 138 1,762 0.8 4.6 3.3 1.3 4.9
Fair 1,105 1.4 76 179 1,162 1.3 4.5 4.6 2 2.7
Poor 443 2.2 177 468 1,226 4.8 6.1 7.3 0.9 2.1
aExpenses for visits to medical providers seen in hospital outpatient departments are included.

bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

†Standard error approximately zero because of poststratification to Census Bureau population control tables.

—Less than 100 sample cases.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table F. Standard errors for emergency room servicesa ?Median and mean expenses per person with expenses and distribution of expenses by source of payment: United States, 2000
Corresponds to Table 6
Expense per person
with an expense
--------------------------------------------------------------------------------
Percent distribution of total expenses
by source of payment
--------------------------------------------------------------------------------

< Population
characteristic
Population
(in thousands) Percent with expense Median Mean Total expenses
(in millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Standard Error

--------------------------------------------------------------------------------

Total † 0.3 10 22 1,263 0.9 2.1 1.7 0.8 2.2

Age in years
Under 65 † 0.3 10 23 1,086 1.1 2.2 0.7 1.1 2.7
Under 6 † 0.9 17 52 198 2.5 5.7 0.2 4.9 2.7
6-17 † 0.6 22 58 335 1.7 7.8 0.4 3.3 10.3
18-44 † 0.4 18 31 649 1.9 2.9 0.5 1.7 2.7
45-64 † 0.5 32 41 368 1.7 4.1 2 0.9 3.8
65 and over † 1 27 62 468 0.9 2.3 3.2 0.5 3.3
Sex
Male † 0.3 14 36 739 1.1 3 1.9 1.2 3.9
Female † 0.4 12 27 776 1.2 2.6 2.6 1.1 1.1
Race/ethnicity
White and other † 0.3 11 26 1,151 0.9 2.6 2.1 1 2.6
Black † 0.7 20 50 333 1.9 4.2 3.5 2.1 6.3
Hispanic † 0.5 17 59 271 3.9 5.8 4.4 2.9 2.5
Health insurance statusd
Under age 65:
Any private 8,688 0.3 15 23 872 0.9 1.9 0.3 0.8 1.9
Public only 1,863 1 14 32 245 1.5 0 3.9 4.4 3.7
Uninsured 1,710 0.8 31 120 346 9.3 0 0 0 9.3
Age 65 and over:
Medicare only 729 1.3 46 129 265 1.6 0 8.5 0 8.7
Medicare and private 971 1.2 33 77 317 1.4 3.3 2.8 0.3 1.7
Medicare and other public 280 2.7 — — — — — — — —
Poverty statuse
Poor † 0.8 18 58 370 1.8 5.3 5.7 4.1 4.9
Near-poor † 1.4 36 82 192 2.5 7.2 7.4 4.5 8.1
Low income † 0.7 19 66 420 3.7 4 4.6 1.6 7.7
Middle income † 0.5 21 32 659 1.4 2.9 3 0.6 2.6
High income † 0.4 24 30 414 1.1 2.7 2.1 1.3 0.9
Metropolitan statistical area (MSA)
MSA † 0.3 11 25 1,180 1 2.4 1.9 0.9 2.6
Non-MSA † 0.8 24 41 421 1.8 4.4 4.4 1.9 3.1
Census region
Northeast † 0.8 22 38 392 1.5 3.9 3.1 2.2 3.1
Midwest † 0.6 19 55 600 0.9 4.4 3.3 2.1 5.6
South † 0.5 14 38 754 2.1 3.1 2.6 1.1 3.1
West † 0.6 26 41 694 1.3 5.6 5.1 1.2 2.4
Perceived health status
Excellent 3,445 0.4 18 43 420 1.4 4 1.1 2.1 4.1
Very good 4,684 0.4 18 46 572 1.6 5.1 1.7 1.7 6.3
Good 3,479 0.5 23 46 570 2 2.9 3.3 1.4 1.9
Fair 1,105 1.2 32 60 305 2.1 4.2 4.7 2 1.7
Poor 443 2 43 85 260 1.9 4 6.4 2.4 4.8
aExpenses for visits to medical providers seen in emergency rooms (except visits resulting in an overnight hospital stay) are included.
bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

†Standard error approximately zero because of poststratification to Census Bureau population control tables.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table G. Standard errors for prescription medicinesa ?Median and mean expenses per person with expenses and distribution of expenses by source of payment: United States, 2000
Corresponds to Table 7
Expense per person
with an expense
--------------------------------------------------------------------------------
Percent distribution of total expenses
by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in thousands) Percent with expense Median Mean Total expenses
(in millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Standard Error

--------------------------------------------------------------------------------

Total † 0.5 5 12 4,936 0.8 1 0.5 0.9 0.4

Age in years
Under 65 † 0.6 3 12 4,061 0.9 1.2 0.3 1.1 0.4
Under 6 † 1.4 3 7 118 2.7 3.4 0.1 3.9 0.8
6-17 † 1 4 20 492 2.9 4.3 0.1 3.6 1.9
18-44 † 0.7 4 16 1,749 1.4 2.1 0.1 2.5 0.2
45-64 † 0.9 20 30 2,431 1.4 1.5 0.4 1.1 0.6
65 and over † 0.7 26 31 1,551 1.4 1.3 1.1 1 0.7
Sex
Male † 0.7 7 16 2,555 1 1.4 0.5 1.5 0.8
Female † 0.7 7 18 2,921 1.1 1.3 0.6 1 0.1
Race/ethnicity
White and other † 0.6 7 14 4,662 0.9 1.1 0.6 0.9 0.4
Black † 1.3 9 31 895 2.3 2.1 1.1 3.3 1.8
Hispanic † 1.1 5 25 739 2.3 1.9 1 3.1 0.9
Health insurance statusd
Under age 65:
Any private 8,688 0.7 4 14 3,103 1 1 0.2 0.6 0.3
Public only 1,863 1.5 12 48 1,443 2.5 0 1 2.4 1.2
Uninsured 1,710 1 6 28 445 2.2 0 0 0 2.2
Age 65 and over:
Medicare only 729 1.3 49 51 861 2.4 0 2.4 0 1.7
Medicare and private 971 0.9 32 42 1,201 1.7 1.6 1.2 0.5 0.6
Medicare and other public 280 2.1 89 121 520 3.1 0 1.5 3.7 1.3
Poverty statuse
Poor † 1.2 17 41 1,212 2.5 1.6 0.9 3 0.7
Near-poor † 2 39 68 627 3.5 1.5 1.5 3.4 1
Low income † 1.3 17 41 1,087 2.4 1.9 1 3.1 1.2
Middle income † 0.8 8 17 1,709 1.2 1.3 1 1.1 0.7
High income † 0.8 8 20 2,321 1.2 1.3 0.5 0.3 0.5
Metropolitan statistical area (MSA)
MSA † 0.6 6 13 4,517 0.9 1.1 0.6 1.1 0.4
Non-MSA † 1.1 15 29 2,008 1.7 1.9 0.5 1.3 0.9
Census region
Northeast † 1.2 11 28 1,597 2.2 2.5 1.3 1.7 0.7
Midwest † 1.4 14 28 2,339 1.8 2.4 0.7 2.1 0.5
South † 0.8 10 19 2,488 1.1 1.5 0.2 1.5 0.5
West † 1.3 8 19 3,051 1.4 1.8 2.5 1.3 1.1
Perceived health status
Excellent 3,445 0.9 3 11 700 1.8 2.1 0.5 2.7 0.5
Very good 4,684 0.7 7 13 1,582 1 1.4 0.7 1.2 0.4
Good 3,479 0.9 16 23 1,781 1.3 1.3 0.8 1.2 0.6
Fair 1,105 0.9 50 64 1,709 2.1 2.3 1 1.8 0.7
Poor 443 1.2 94 79 901 2.5 2.1 1.2 2.4 2
aExpenses for all prescribed medicines initially purchased or otherwise obtained during the year, as well as any refills, are included. Free samples are included in the estimate of percent of persons with any expense.
bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

†Standard error approximately zero because of poststratification to Census Bureau population control tables.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table H. Standard errors for dental servicesa ?Median and mean expenses per person with expenses and distribution of expenses by source of payment: United States, 2000
Corresponds to Table 8
Expense per person
with an expense
--------------------------------------------------------------------------------
Percent distribution of total expenses
by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in thousands) Percent with expense Median Mean Total expenses
(in millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Standard Error

--------------------------------------------------------------------------------

Total † 0.7 4 14 2,879 1.1 1.1 0.1 0.9 0.4

Age in years
Under 65 † 0.8 4 17 2,545 1.3 1.2 0 1 0.4
Under 6 † 1.3 7 21 128 3.3 4.2 0 6.7 2.5
6-17 † 1.1 7 50 1,466 2.9 3.3 0 1.6 0.4
18-44 † 0.8 6 17 1,000 1.7 1.9 0 2.4 0.7
45-64 † 1.4 9 23 908 1.5 1.6 0 0.3 0.8
65 and over † 1.3 11 34 668 2.2 1.9 0.9 0.1 1
Sex
Male † 0.7 5 18 1,506 1.3 1.5 0.2 1.6 0.7
Female † 0.9 5 23 1,898 1.6 1.7 0.2 0.8 0.4
Race/ethnicity
White and other † 0.8 4 16 2,793 1.2 1.1 0.1 1 0.4
Black † 1.3 6 41 453 4.1 4.7 0.1 1.5 1
Hispanic † 1.1 9 32 298 3.1 2.6 0.2 1.1 1.2
Health insurance statusd
Under age 65:
Any private 8,688 0.9 4 20 2,400 1.3 1.1 0 0.8 0.4
Public only 1,863 1.3 6 33 367 4.6 0 0.3 4.7 1.8
Uninsured 1,710 1.1 10 50 369 3.7 0 0 0 3.7
Age 65 and over:
Medicare only 729 2 25 72 337 3 0 2 0 2.6
Medicare and private 971 1.7 11 38 518 2.6 2.4 0.4 0 0.4
Medicare and other public 280 2.2 — — — — — — — —
Poverty statuse
Poor † 1.2 8 36 348 4.1 4.6 1.8 4.4 2.5
Near-poor † 2 22 134 495 9.4 8.5 0.2 16.2 3.1
Low income † 1.3 10 31 453 3.2 2.5 0.2 2.7 1.4
Middle income † 0.9 7 26 1,534 2.2 1.9 0.3 1.4 0.7
High income † 1.1 5 28 1,812 1.6 1.6 0.1 0.1 0.5
Metropolitan statistical area (MSA)
MSA † 0.8 5 16 2,599 1.2 1.3 0.2 1 0.4
Non-MSA † 1.5 10 43 1,369 1.9 1.9 0.1 0.5 0.9
Census region
Northeast † 1.7 8 27 1,548 1.7 2 0.4 1.1 0.8
Midwest † 1.6 7 25 1,143 1.5 1.6 0.1 1.4 0.7
South † 1.1 6 28 1,432 2.6 2.7 0.2 0.2 0.7
West † 1.4 9 45 1,556 2.9 2.3 0.4 3 0.7
Perceived health status
Excellent 3,445 0.9 5 28 1,099 2.6 2.6 0.1 0.8 0.5
Very good 4,684 0.9 5 25 1,600 1.5 1.6 0.2 0.4 0.6
Good 3,479 1 7 24 1,089 2.9 2 0.4 3.4 1
Fair 1,105 1.6 15 42 385 3.4 2.7 0.2 0.9 1.7
Poor 443 2.2 35 71 187 5.7 4.8 1.5 7.7 1.6
aServices provided by general dentists, dental hygienists, dental technicians, dental surgeons, orthodontists, endodontists, and periodontists are included.
bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

ePoor—persons in families with income less than 100 percent of the poverty line, including those whose losses exceeded their earnings, resulting in negative income; near poor—persons in families with income from 100 percent to less than 125 percent of the poverty line; low income—persons in families with income from 125 percent to less than 200 percent of the poverty line; middle income—persons in families with income from 200 percent to less than 400 percent of the poverty line; high income—persons in families with income at or over 400 percent of the poverty line.

†Standard error approximately zero because of poststratification to Census Bureau population control tables.

—Less than 100 sample cases.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table I. Standard errors for home health servicesa ?Median and mean expenses per person with expenses and distribution of expenses by source of payment: United States, 2000
Corresponds to Table 9
Expense per person
with an expense
--------------------------------------------------------------------------------
Percent distribution of total expenses
by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in thousands) Percent with expense Median Mean Total expenses
(in millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Standard Error

--------------------------------------------------------------------------------

Total † 0.1 176 664 3,821 3.1 1.3 4.8 7.1 3.5

Age in years
Under 65 † 0.1 278 1,446 3,284 2.3 1.4 5.6 9.4 6.7
Under 6 † 0.4 — — — — — — — —
6-17 † 0.2 — — — — — — — —
18-44 † 0.1 — — — — — — — —
45-64 † 0.2 — — — — — — — —
65 and over † 0.7 204 468 1,713 5.1 2.2 5.7 6.2 1.6
Sex
Male † 0.2 205 600 1,623 5.1 1.8 8 7.1 2
Female † 0.2 240 1,088 3,845 3.8 1.8 3.7 8.2 5.2
Race/ethnicity
White and other † 0.2 184 779 3,572 4 1.6 5.6 9.3 4.6
Black † 0.3 — — — — — — — —
Hispanic † 0.2 — — — — — — — —
Health insurance statusd
Under age 65:
Any private 8,688 0.1 — — — — — — — —
Public only 1,863 0.5 — — — — — — — —
Uninsured 1,710 0.1 — — — — — — — —
Age 65 and over:
Medicare only 729 1.2 — — — — — — — —
Medicare and private 971 0.9 235 735 1,124 10.9 5.3 11.5 5.9 1.7
Medicare and other public 280 2.6 — — — — — — — —
Poverty statuse
Poor † 0.4 360 941 1,132 8 1.3 9.4 7.6 3.2
Near-poor † 0.9 — — — — — — — —
Low income † 0.4 — — — — — — — —
Middle income † 0.2 268 713 1,166 4.4 2 7.5 10.9 14.4
High income † 0.1 — — — — — — — —
Metropolitan statistical area (MSA)
MSA † 0.1 167 744 3,196 3.9 1.6 4.3 7.5 4.6
Non-MSA † 0.3 406 1,363 1,975 3.8 1.2 16.1 18.2 1.8
Census region
Northeast † 0.3 — — — — — — — —
Midwest † 0.3 — — — — — — — —
South † 0.2 172 1,460 2,465 6.7 2.3 9.4 15.4 1.6
West † 0.2 — — — — — — — —
Perceived health status
Excellent 3,445 0.1 — — — — — — — —
Very good 4,684 0.1 — — — — — — — —
Good 3,479 0.2 — — — — — — — —
Fair 1,105 0.7 267 2,013 3,043 5.2 1.1 8.1 12.7 2.7
Poor 443 1.8 426 714 1,053 5.5 4.6 10.2 6.2 1.1
aExpenses for care provided by home health agencies and independent home health providers are included. Most home health expenses (87.5 percent) were for agency providers.
bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

†Standard error approximately zero because of poststratification to Census Bureau population control tables.

—Less than 100 sample cases.

Note: Restricted to civilian noninstitutionalized population. Percents may not add to 100 because of rounding.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

Table J. Standard errors for medical equipment and servicesa ?Median and mean expenses per person with expenses
and distribution of expenses by source of payment: United States, 2000
Corresponds to Table 10
Expense per person
with an expense
--------------------------------------------------------------------------------
Percent distribution of total expenses
by source of payment
--------------------------------------------------------------------------------

Population
characteristic
Population
(in thousands) Percent with expense Median Mean Total expenses
(in millions) Out of pocket Private insuranceb Medicare Medicaid Otherc
Standard Error

--------------------------------------------------------------------------------

Total † 0.4 4 6 765 1.6 1.3 0.6 1 0.5

Age in years
Under 65 † 0.4 5 6 664 1.7 1.5 0.2 1.2 0.4
Under 6 † 0.4 — — — — — — — —
6-17 † 0.7 7 10 100 3.1 2.1 0.1 3.8 0.4
18-44 † 0.5 4 9 285 2 1.8 0.1 2.1 0.6
45-64 † 0.9 7 13 403 2.8 2.6 0.5 1.7 0.4
65 and over † 1.2 7 24 310 2.8 1.1 1.9 1.3 1.4
Sex
Male † 0.5 6 11 394 2.4 1.7 1 1.7 1
Female † 0.6 6 8 454 1.8 1.4 0.6 1.2 0.4
Race/ethnicity
White and other † 0.5 5 6 721 1.7 1.4 0.7 1 0.5
Black v 0.7 11 23 125 4.6 2.1 0.9 3.5 1
Hispanic † 0.7 11 20 177 3.7 4.3 0.5 5.5 0.8
Health insurance statusd
Under age 65:
Any private 8,688 0.5 6 6 571 1.7 1.7 0 0.6 0.3
Public only 1,863 1.1 9 37 188 3.7 0 2.3 3.8 0.7
Uninsured 1,710 0.7 12 20 89 2.9 0 0 0 2.9
Age 65 and over:
Medicare only 729 1.8 15 39 130 5.5 0 5.8 0 2.3
Medicare and private 971 1.6 9 33 245 3.1 1.8 1.2 0.1 2.1
Medicare and other public 280 2.5 29 53 59 7.8 0 3.2 8.4 0.9
Poverty statuse
Poor † 0.8 8 24 137 5.1 1.3 1.2 5.8 1.8
Near-poor † 1.4 16 28 74 7.5 5.2 4.8 7.3 0.9
Low income † 0.9 9 21 173 3.2 1.8 1.9 1.8 0.8
Middle income † 0.7 5 12 319 2.7 1.6 1.7 1.6 1.4
High income † 0.7 3 10 492 2.2 2.2 0.3 1.2 0.4
Metropolitan statistical area (MSA)
MSA † 0.4 6 7 706 1.9 1.5 0.4 1.2 0.5
Non-MSA † 1.2 7 13 305 2.9 2.7 2.4 0.9 0.7
Census region
Northeast † 0.9 9 14 196 1.6 2.4 1.3 0.9 0.7
Midwest † 1 9 14 357 3.1 2.9 0.3 0.9 1
South † 0.6 6 12 343 3.2 1.3 1.3 2.7 1
West † 0.9 9 9 545 2.9 3.3 1 1.8 0.5
Perceived health status
Excellent 3,445 0.7 7 14 295 2.6 2.5 0.7 0.5 0.4
Very good 4,684 0.7 7 10 321 2.2 2 0.6 1.9 1.1
Good 3,479 0.6 6 11 241 2.6 1.6 1.8 1.6 0.7
Fair 1,105 1.2 13 37 202 3.8 2.1 1.1 1.9 0.8
Poor 443 2 18 45 130 6.1 2.9 1.3 7.6 2.6
aExpenses for eyeglasses, contact lenses, ambulance services, orthopedic items, hearing devices, prostheses, bathroom aids, medical equipment, disposable supplies, alterations/modifications, and other miscellaneous items or services that were obtained, purchased, or rented during the year are included. About two-thirds of the expenditures in this category were for vision items.
bPrivate insurance includes TRICARE (Armed-Forces-related coverage).

†Standard error approximately zero because of poststratification to Census Bureau population control tables.

—Less than 100 sample cases.

Note: Restricted to civilian noninstitutionalized population.

Source: Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey, 2000.

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Internet Citation:
Research Findings #21: Health Care Expenses in the United States, 2000. April 2004. Agency for Healthcare Research and Quality, Rockville, MD. http://www.meps.ahrq.gov/papers/rf21_04-0022/rf21.htm

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