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National Healthcare Disparities Report, 2003

Receipt of Care

Health Care Expenditures

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Overall Expenditures
Percent of persons with any health care expenditures.
Mean total expenditures among persons with expenditures.
Mean Expenditures among Users by Type of Service
Mean office-based/outpatient department expenditures among persons with office-based/outpatient department expenditures.
Mean prescription expenditures among persons with prescription expenditures.
Mean dental expenditures among persons with dental expenditures.
Mean emergency room expenditures among persons with emergency room expenditures.
Mean inpatient expenditures among persons with inpatient expenditures.
Percent of Expenditure Paid by Medicaid
Proportion of total health care expenditures paid by Medicaid.
Proportion of office-based/outpatient department expenditures paid by Medicaid.
Proportion of prescription expenditures paid by Medicaid.
Proportion of dental expenditures paid by Medicaid.
Proportion of emergency room expenditures paid by Medicaid.
Proportion of inpatient expenditures paid by Medicaid.
Percent of Expenditure Paid Out-of-Pocket
Proportion of total health care expenditures paid out-of-pocket.
Proportion of office-based/outpatient department expenditures paid out-of-pocket.
Proportion of prescription expenditures paid out-of-pocket.
Proportion of dental expenditures paid out-of-pocket.
Proportion of emergency room expenditures paid out-of-pocket.
Proportion of inpatient expenditures paid out-of-pocket.
Medicare Expenditures in the Last Year of Life
Mean total Medicare expenditures in the last year of life.


Overall Expenditures

Measure Title

Percent of persons with any health care expenditures.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Percent of persons with any health care expenditures, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

U.S. population (civilian, non-institutionalized).

Numerator

U.S. population (civilian, non-institutionalized) who reported having health care expenditures (i.e., health care expenses >$0).

Comments

Total health care expenditures in MEPS are defined as the sum of payments for health care services from all sources.

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Overall Expenditures

Measure Title

Mean total expenditures among persons with expenditures.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Mean total expenditures among persons with expenditures, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

U.S. population (civilian, non-institutionalized) who reported having health care expenditures (i.e., health care expenses >$0).

Numerator

Total health care expenditures.

Comments

Total health care expenditures in MEPS are defined as the sum of payments from all sources.

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Mean Expenditures among Users by Type of Service

Measure Title

Mean office-based/outpatient department expenditures among persons with office-based/outpatient department expenditures.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Mean office-based/outpatient department expenditures among persons with office-based/outpatient department expenditures, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

U.S. population (civilian, non-institutionalized) who reported having office-based/outpatient department expenditures.

Numerator

Total office-based/outpatient expenditures.

Comments

Office-based/outpatient department expenditures include:

Office-based expenditures (physician and non-physician)

Outpatient department expenditures (physician and non-physician)

Inpatient expenditures for visits where the admission date was the same as the discharge date (i.e., "zero-night" stays).

Total office-based/outpatient department expenditures in MEPS are defined as the sum of payments for office-based/outpatient department services from all sources.

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Mean Expenditures among Users by Type of Service

Measure Title

Mean prescription expenditures among persons with prescription expenditures.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Mean prescription expenditures among persons with prescription expenditures, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

U.S. population (civilian, non-institutionalized) who reported having prescription expenditures (i.e., prescription expenses >$0).

Numerator

Total prescription expenditures.

Comments

Total prescription medication expenditures in MEPS are defined as the sum of payments for prescription medications from all sources.

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Mean Expenditures among Users by Type of Service

Measure Title

Mean dental expenditures among persons with dental expenditures.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Mean dental expenditures among persons with dental expenditures, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

U.S. population (civilian, non-institutionalized) who reported having dental expenditures (i.e., dental expenses >$0).

Numerator

Total dental expenditures.

Comments

Total dental expenditures in MEPS are defined as the sum of payments for dental services from all sources.

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Mean Expenditures among Users by Type of Service

Measure Title

Mean emergency room expenditures among persons with emergency room expenditures.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Mean emergency room expenditures among persons with emergency room expenditures, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

U.S. population (civilian, non-institutionalized) who reported having emergency room expenditures (i.e., emergency room expenses >$0).

Numerator

Total emergency room expenditures.

Comments

Total emergency room expenditures in MEPS are defined as the sum of payments for emergency room services from all sources.

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Mean Expenditures among Users by Type of Service

Measure Title

Mean inpatient expenditures among persons with inpatient expenditures.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Mean inpatient expenditures among persons with inpatient expenditures, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

U.S. population (civilian, non-institutionalized) who reported having inpatient expenditures (i.e., inpatient expenses >$0, excluding "zero-night" inpatient expenses).

Numerator

Total inpatient expenditures (excluding "zero-night" inpatient expenses).

Comments

Inpatient expenditures exclude those for inpatient visits where the admission date was the same as the discharge date (i.e., "zero-night" stays).

Total inpatient expenditures in MEPS are defined as the sum of payments for inpatient services from all sources.

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Percent of Expenditure Paid by Medicaid

Measure Title

Proportion of total health care expenditures paid by Medicaid.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Proportion of total health care expenditures paid by Medicaid, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Total health care expenditures.

Numerator

Total health care expenditures paid by Medicaid.

Comments

Total health care expenditures in MEPS are defined as the sum of payments for health care services from all sources.

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Percent of Expenditure Paid by Medicaid

Measure Title

Proportion of office-based/outpatient department expenditures paid by Medicaid.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Proportion of office-based/outpatient department expenditures paid by Medicaid, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Total office-based/outpatient department expenditures.

Numerator

Total office-based/outpatient department expenditures paid by Medicaid.

Comments

Office-based/outpatient department expenditures include:

Office-based expenditures (physician and non-physician)

Outpatient department expenditures (physician and non-physician)

Inpatient expenditures for visits where the admission date was the same as the discharge date (i.e., "zero-night" stays).

Total office-based/outpatient department expenditures in MEPS are defined as the sum of payments for office-based/outpatient department services from all sources.

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Percent of Expenditure Paid by Medicaid

Measure Title

Proportion of prescription expenditures paid by Medicaid.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Proportion of prescription expenditures paid by Medicaid, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Total prescription expenditures.

Numerator

Total prescription expenditures paid by Medicaid.

Comments

Total prescription medication expenditures in MEPS are defined as the sum of payments for prescription medications from all sources.

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Percent of Expenditure Paid by Medicaid

Measure Title

Proportion of dental expenditures paid by Medicaid.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Proportion of dental expenditures paid by Medicaid, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Total dental expenditures.

Numerator

Total dental expenditures paid by Medicaid.

Comments

Total dental expenditures in MEPS are defined as the sum of payments for dental services from all sources.

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Percent of Expenditure Paid by Medicaid

Measure Title

Proportion of emergency room expenditures paid by Medicaid.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Proportion of emergency room expenditures paid by Medicaid, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Total emergency room expenditures.

Numerator

Total emergency room expenditures paid by Medicaid.

Comments

Total emergency room expenditures in MEPS are defined as the sum of payments for emergency room services from all sources.

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Percent of Expenditure Paid by Medicaid

Measure Title

Proportion of inpatient expenditures paid by Medicaid.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Proportion of inpatient expenditures paid by Medicaid, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Total inpatient expenditures.

Numerator

Total inpatient expenditures paid by Medicaid.

Comments

Inpatient expenditures exclude those for inpatient visits where the admission date was the same as the discharge date (i.e., "zero-night" stays).

Total inpatient expenditures in MEPS are defined as the sum of payments for inpatient services from all sources.

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Percent of Expenditure Paid Out-of-Pocket

Measure Title

Proportion of total health care expenditures paid out-of-pocket.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Proportion of total health care expenditures paid out-of-pocket, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Total health care expenditures.

Numerator

Total health care expenditures paid out-of-pocket.

Comments

Total health care expenditures in MEPS are defined as the sum of payments for health care services from all sources.

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Percent of Expenditure Paid Out-of-Pocket

Measure Title

Proportion of office-based/outpatient department expenditures paid out-of-pocket.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Proportion of office-based/outpatient department expenditures paid out-of-pocket, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Total office-based/outpatient department expenditures.

Numerator

Total office-based/outpatient department expenditures paid out-of-pocket.

Comments

Office-based/outpatient department expenditures include:

Office-based expenditures (physician and non-physician)

Outpatient department expenditures (physician and non-physician)

Inpatient expenditures for visits where the admission date was the same as the discharge date (i.e., "zero-night" stays).

Total office-based/outpatient department expenditures in MEPS are defined as the sum of payments for office-based/outpatient department services from all sources.

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Percent of Expenditure Paid Out-of-Pocket

Measure Title

Proportion of prescription expenditures paid out-of-pocket.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Proportion of prescription expenditures paid out-of-pocket, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Total prescription expenditures.

Numerator

Total prescription expenditures paid out-of-pocket.

Comments

Total prescription medication expenditures in MEPS are defined as the sum of payments for prescription medications from all sources.

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Percent of Expenditure Paid Out-of-Pocket

Measure Title

Proportion of dental expenditures paid out-of-pocket.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Proportion of dental expenditures paid out-of-pocket, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Total dental expenditures.

Numerator

Total dental expenditures paid out-of-pocket.

Comments

Total dental expenditures in MEPS are defined as the sum of payments for dental services from all sources.

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Percent of Expenditure Paid Out-of-Pocket

Measure Title

Proportion of emergency room expenditures paid out-of-pocket.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Proportion of emergency room expenditures paid out-of-pocket, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Total emergency room expenditures.

Numerator

Total emergency room expenditures paid out-of-pocket.

Comments

Total emergency room expenditures in MEPS are defined as the sum of payments for emergency room services from all sources.

Top of Page


Percent of Expenditure Paid Out-of-Pocket

Measure Title

Proportion of inpatient expenditures paid out-of-pocket.

Measure Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Tables

Proportion of inpatient expenditures paid out-of-pocket, United States, 1999, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Total inpatient expenditures.

Numerator

Total inpatient expenditures paid out-of-pocket.

Comments

Inpatient expenditures exclude those for inpatient visits where the admission date was the same as the discharge date (i.e., "zero-night" stays).

Total inpatient expenditures in MEPS are defined as the sum of payments for inpatient services from all sources.

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Medicare Expenditure in the Last Year of Life

Measure Title

Mean total Medicare expenditures in the last year of life.

Measure Source

Lisa R. Shugarman, Ph.D. and Joanne Lynn, M.D., M.S., RAND.

Tables

Mean total Medicare expenditures in the last year of life, United States, 1996-1999, by

  • Race

Data Source

Centers for Medicare and Medicaid Services (CMS); inpatient, outpatient, skilled nursing facility (SNF), home health, hospice, and physician/supplier Standard Analytic Files.

Population

Elderly Medicare fee-for-service beneficiaries who were continuously enrolled in both Part A (Hospital Insurance) and Part B (Supplemental Medical Insurance) for 36 months prior to their death between January 1, 1996 and December 31, 1999. We excluded beneficiaries qualifying for Medicare with ESRD or disability and those enrolled in Medicare+Choice capitated coverage. Because the 'other' race category comprised a small proportion of our sample (2.0%), we excluded them, retaining only white and black beneficiaries.

Comments

The principal outcome measure is total annual Medicare expenditures for each of three years prior to death. Medicare expenditures are the sum of inflation-adjusted (to 1999 dollars) Medicare program payments to providers for each of six service types: inpatient, outpatient, skilled nursing, home health, hospice, and physician. Deductibles, co-insurance, durable medical equipment, payment by other insurance, and out-of-pocket expenses are not included.


 

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