Spending on children’s personal health care in the United States, 1996-2013.
Open accessAbstract
Importance: Health care spending on children in the United States continues to rise, yet little is known about how this spending varies by condition, age and sex group, and type of care, nor how these patterns have changed over time. Objective: To provide health care spending estimates for children and adolescents 19 years and younger in the United States from 1996 through 2013, disaggregated by condition, age and sex group, and type of care. Evidence Review: Health care spending estimates were extracted from the Institute for Health Metrics and Evaluation Disease Expenditure 2013 project database. This project, based on 183 sources of data and 2.9 billion patient records, disaggregated health care spending in the United States by condition, age and sex group, and type of care. Annual estimates were produced for each year from 1996 through 2013. Estimates were adjusted for the presence of comorbidities and are reported using inflation-adjusted 2015 US dollars. Findings: From 1996 to 2013, health care spending on children increased from $149.6 (uncertainty interval [UI], 144.1-155.5) billion to $233.5 (UI, 226.9-239.8) billion. In 2013, the largest health condition leading to health care spending for children was well-newborn care in the inpatient setting. Attention-deficit/hyperactivity disorder and well-dental care (including dental check-ups and orthodontia) were the second and third largest conditions, respectively. Spending per child was greatest for infants younger than 1 year, at $11 741 (UI, 10 799-12 765) in 2013. Across time, health care spending per child increased from $1915 (UI, 1845-1991) in 1996 to $2777 (UI, 2698-2851) in 2013. The greatest areas of growth in spending in absolute terms were ambulatory care among all types of care and inpatient well-newborn care, attention-deficit/hyperactivity disorder, and asthma among all conditions. Conclusions and Relevance: These findings provide health policy makers and health care professionals with evidence to help guide future spending. Some conditions, such as attention-deficit/hyperactivity disorder and inpatient well-newborn care, had larger health care spending growth rates than other conditions.
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- Authors
- Bui, A. L., Dieleman, J. L., Hamavid, H., Birger, M., Chapin, A., Duber, H. C., Horst, C., Reynolds, A., Squires, E., Chung, P. J., & Murray, C. J. L.
- Affiliations
- University of California, Los Angeles (US)
- Institute for Health Metrics and Evaluation (US)
- University of Washington (US)
- RAND Corporation (US)
- Corresponding author
- Dieleman, Joseph L.
- ORCID
- Venue
- JAMA Pediatrics
- Publisher
- American Medical Association (AMA)
- Published
- 2017-02-01
- Volume
- 171
- Issue
- 2
- Pages
- 181
- ISSN
- 1072-4710 (ISSN-L)
- 2168-6203
- PMC
- PMC5546095
- OpenAlex
- W2567003762
- Cited by
- 151
- References
- 37
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 24 · 2023: 13 · 2022: 14 · 2021: 19 · 2020: 26 · 2019: 16 · 2018: 23 · 2017: 5 · 2016: 1
- FWCI
- 29.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Pediatrics and Adolescent Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute on Aging (P30AG047845)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Health Professions › General Health Professions › Global Health Care Issues
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Keywords
- health care spending, children, adolescents, neonatal care, attention deficit hyperactivity disorder, asthma, dental care, outpatient care, inpatient care, comorbidity adjustment, well-child visits, health policy
- MeSH terms
- Child Health, Adolescent, Child, Child, Preschool, Health Expenditures, Female, Humans, Infant, Infant, Newborn, Male, United States, Young Adult
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