STATISTICAL BRIEF #27: National Health Care Expenses in the U.S. Community Population, 2000
2003
By: Gary L. Olin, Ph.D.
Highlights
Health care expenses of the community population reached $627.8 billion in 2000, with over a third of the expenses related to hospital inpatient services (approximately 37% of the total).
Overall, the mean and median expenses of persons with expenses (approximately 84% of the community population) were $2,700 and $721, respectively, in 2000.
Approximately 32% of the expenses were for ambulatory medical care, i.e., services by office-based medical providers, hospital outpatient departments, and emergency rooms. However, emergency room expenses (about 3% of total expenses) were relatively small compared to other ambulatory care expenses.
Prescription medicine purchases accounted for about 16% of community population spending on health care, and the mean expense among those with expenses was $594.
Private medical insurance--the largest third-party payer--covered about 41% of total payments. Medicare and Medicaid--the primary public programs--combined paid about 31% of the total.
Introduction
This Statistical Brief contains data on health care expenses of the U.S. civilian non-institutionalized (community) population in calendar year 2000. Health care expenses in this brief represent payments to hospitals, physicians, and other health care providers for services reported by respondents in the Household Component of the Medical Expenditure Panel Survey (MEPS). These expenses are defined as direct payments by individuals, private insurance, Medicare, Medicaid, and other payment sources. All differences discussed in this Statistical Brief are statistically significant at the 0.05 level.
Findings
In 2000, the U.S. community population had total expenses of $627.8 billion, consisting of payments for hospital inpatient and outpatient care, emergency room services, office- and clinic-based medical provider services, dental services, home health care, prescription medicines, and other medical services and equipment (Figure 1). Among the 83.5% of the population with an expense, the median and mean expenses were $721 and $2,700, respectively. A small proportion of the 16.5% of the population who did not have health care expenses during 2000 received health services for which no expenses were incurred.
Hospital inpatient stays--facility charges and expenses for physician services incurred during a hospital stay--accounted for 36.7% of the total expenses of the community population, while another 20.1% of the total was for office-based medical provider services (Figure 2). The mean expense among those with expenses ranged from $10,917 for hospital inpatient services to $260 for other medical equipment and services (Figure 3), and the proportion of people with expenses varied widely by type of service (Figure 4).
Health care expenses are paid by individuals and third-party payers such as private insurance and public programs. In 2000, private insurance covered 40.5% of the total expenses, individuals and family members paid 19.4%; and Medicare and Medicaid combined paid approximately 31% (Figure 5).
As shown in Figures 6 and 7, health care expenses were not uniformly distributed across the community population. At one extreme, uninsured people under age 65 were relatively low users of health care--those with expenses had a mean expense of $1,500. At the other extreme, people age 65 and older on Medicare and other public insurance were heavy users--those with expenses had a mean expense of $8,324.
About MEPS
The estimates in this Statistical Brief are based on data from the 2000 MEPS household Component (MEPS-HC). MEPS is a nationally representative longitudinal survey that collects detailed information on health care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, demographic, and economic characteristics for the civilian non-institutionalized population. More information about MEPS can be found at the MEPS Web site at http://www.meps.ahrq.gov/.
Figure 1: Health Care Expenses of the U.S. Community Population, 2000
Total Community Expenses = $627.8 billion
Median Expense for Persons with Expenses = $721
Mean Expense for Persons with Expenses = $2,700
With Expenses
With No Expenses
Percent
83.5
16.5
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey--Household Component, 2000
Figure 2: Distribution of Health Care Spending in the U.S. Community Population, by Type of Service, 2000
Hospital Inpatient
Office-Based Medical Provider
Prescription Medicines
Dental Services
Hospital Outpatient
Home Health
Emergency Room
Other Medical
Percent of Total Expenses
36.7
20.1
16.4
8.9
8.7
4.1
3.1
2.1
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey--Household Component, 2000
Figure 3: Mean Expense per Person with an Expense in the U.S. Community Population, by Type of Service, 2000
Total
Hospital Inpatient
Office-Based Medical Provider
Prescription Medicines
Dental Services
Hospital Outpatient
Home Health
Emergency Room
Other Medical
Dollars
2700
10917
657
594
498
1501
5136
594
260
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey--Household Component, 2000
Figure 4: Proportion of the U.S. Community Population with an Expense, by Type of Service, 2000
Any Expense
Hospital Inpatient
Office-Based Medical Provider
Prescription Medicines
Dental Services
Hospital Outpatient
Home Health
Emergency Room
Other Medical
Percent
83.5
7.6
68.8
62.3
40.1
13.1
1.8
11.6
3.7
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey--Household Component, 2000
Figure 5: Distribution of Payments by Source for the U.S. Community Population, 2000
Out of Pocket
Private Insurance
Medicare
Medicaid
Other
Percent
19.4
40.5
20.9
9.8
9.5
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey--Household Component, 2000
Figure 6: Health Care Expenses Relative to Percent of Population, by Insurance Status, 2000
Any Private (People Under 65)
Public Only (People Under 65)
Uninsured (People Under 65)
Medicare Only (People 65 and Older)
Medicare/Private (People 65 and Older)
Medicare/Other Public (People 65 and Older)
Percent Population
65.6
10.3
11.6
4.1
7.0
1.3
Percent Expenses
51.0
12.0
4.4
9.0
18.8
4.6
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey--Household Component, 2000
Figure 7: Mean and Median Expenses of Persons with Expenses in the U.S. Community Population, by Insurance Status, 2000
Total (People Under 65)
Any Private (People Under 65)
Public Only (People Under 65)
Uninsured (People Under 65)
Total (People 65 and Older)
Medicare Only (People 65 and Older)
Medicare/Private (People 65 and Older)
Medicare/Other Public (People 65 and Older)
Mean
$2127
$2042
$3170
$1500
$6140
$5206
$6276
$8324
Median
$586
$638
$465
$305
$2278
$2033
$2362
$3094
Source: Center for Financing, Access, and Cost Trends, AHRQ, Medical Expenditure Panel Survey--Household Component, 2000
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