Highlights

• For those under 18 years of age, these five medical conditions-mental disorders, asthma, trauma-related disorders, acute bronchitis and upper respiratory infections, and otitis media-ranked highest in terms of direct medical spending in 2011.
• Of the five most costly conditions for children, mental disorders affected the fewest children but had the highest average expense per child.
• Treatment of mental disorders ($13.8 billion) accounted for the highest total expense and acute bronchitis and URI ($3.3 billion), and otitis media ($3.2 billion) accounted for the lowest among the top five most expensive children's conditions in 2011.
• Nearly half of the expenditures for mental disorders (48.4 percent) and asthma (49.1 percent) in children were paid by Medicaid.

Introduction

This Statistical Brief presents data from the Household Component of the Medical Expenditure Panel Survey (MEPS-HC) regarding medical expenditures associated with the five most costly conditions for children ages 0-17 in 2011. These conditions (mental disorders; asthma/chronic obstructive pulmonary disease (COPD); trauma-related disorders; acute bronchitis and upper respiratory infections (URI); and otitis media (ear infections)) were determined by totaling and ranking the expenses by condition for all medical care provided in 2011. Only differences between the estimates that are statistically significant at the 0.05 level are discussed in the text.

Findings

In 2011, a total of $117.6 billion was spent for the medical care and treatment of children. The top five conditions in terms of total health care expenditures were mental disorders, asthma (including chronic obstructive pulmonary disease), trauma-related disorders, acute bronchitis and upper respiratory infections, and otitis media.

The highest expenditure total was for care and treatment of mental disorders in children. Total expenditures to treat mental disorders were $13.8 billion (Figure 1). There were 5.6 million children who were treated for mental disorders (Figure 2). Mean expenditures per child with expenses were highest for mental disorders ($2,465) (Figure 3). Medicaid paid for about half of the amount spent to treat children with mental disorders (48.4 percent) (Figure 4). About 41.5 percent of mental health expenditures on children were for prescription medicines (Figure 5).

Figure 1

Expenditures for the five most costly conditions in children, 2011.

Figure 2

Number of children with expenses for the five most costly conditions, 2011.

Figure 3

Average expenditures per child with expenses for the five most costly conditions, 2011.

Figure 4

Percentage distribution of annual expenditures for the five most costly conditions in children, by source of payment, 2011.

Figure 5

Percentage distribution of annual expenditures for the five most costly conditions in children, by type of service, 2011.

Expenditures for treating asthma/COPD in children totaled $11.9 billion. More than 12 million (12.3) children were treated for asthma in 2011. Mean expenditures per child with expenses for asthma were $969. Medicaid paid for about half of the expenditures incurred to treat asthma (49.1 percent) among children. Inpatient hospitalizations included 29.4 percent of asthma expenditures.

Expenses for the treatment of trauma-related disorders in children totaled $5.8 billion in 2011. This amount was spent to treat a total of 6.7 million children. Mean expenditures per child with expenses for trauma-related disorders were $869 per child. A little less than half (45 percent) of expenditures on trauma-related disorders were incurred for emergency room care.

Expenses on acute bronchitis and upper respiratory infections ($3.3 billion) and otitis media ($3.2 billion) were the lowest among the five most costly conditions for children. In 2011, 11.5 million children were treated for acute bronchitis and upper respiratory infections. Acute bronchitis and upper respiratory expenditures, averaged at $289 per child with expenses, were the lowest per child mean expenditure among the five most costly conditions for children. About two-thirds (61.8 percent) of expenditures on the treatment of acute bronchitis and URI among children were paid by private insurance. More than three-fourths (78.4 percent) of expenditures on the treatment of acute bronchitis & URI were for ambulatory services.

In 2011, 7.5 million children were treated for otitis media, or ear infections. Mean expenditures per child with expenses to treat otitis media were $427. Private insurance was the predominant payer for treatment of otitis media (58.8 percent) in 2011. More than three-fourths (78.6 percent) of expenditures on treatment of otitis media were for ambulatory services.

Data Source

Definitions

About MEPS-HC

References

For a detailed description of the MEPS-HC survey design, sample design, and methods used to minimize sources on non-sampling errors, see the following publications:

• Cohen J. Design and Methods of the Medical Expenditure Panel Survey Household Component. Rockville, MD: Agency for Healthcare Policy and Research; 1997. (MEPS Methodology Report No. 1). AHCPR Pub. No. 97-0026. http://www​.meps.ahrq​.gov/mepsweb/data_files​/publications/mr1/mr1.pdf .
• Cohen S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. Rockville, MD: Agency for Healthcare Research and Quality; 1997. (MEPS Methodology Report No. 2). AHCPR Pub. No. 97-0027. http://www​.meps.ahrq​.gov/mepsweb/data_files​/publications/mr2/mr2.pdf .
• Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care, July 2003: 41(7) Supplement: III-5-III-12. [PubMed: 12865722]
• Cohen, J. , Krauss N. Spending and Service Use among People with the Fifteen Most Costly Medical Conditions, 1997 Health Affairs; 22(2):129-138, 2003. [PubMed: 12674416]
• 2007-2010 Children's Health Care Spending Report. http://www​.healthcostinstitute​.org/news-and-events​/press-release-childrens-health-care-spending-report-2007-2010 .

Suggested Citation