• Paul W Newacheck, Sabrina T Wong, Alison A Galbraith, and Yun-Yi Hung.
• Institute for Health Policy Studies and Department of Pediatrics, University of California-San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94118, USA. pauln@itsa.ucsf.edu
• J Adolesc Health. 2003 Jun 1; 32 (6 Suppl): 3-11.

PurposeTo examine health care spending patterns for U.S. adolescents aged 10 to 18 years using nationally representative household survey data.MethodsWe analyzed data from the 1997 Medical Expenditure Panel Survey on total expenditures and out-of-pocket expenditures for health care based on a sample of 4882 adolescents.ResultsCompared with that for adults, health care expenditures for adolescents were low, averaging $799 US dollars per adolescent in 1997. Disabled and functionally impaired adolescents had disproportionately high expenditures ($1960 US dollars per capita). Blacks and adolescents living in poor families had disproportionately low expenditures ($358 and $609 US dollars per capita, respectively). Professional services provided by physicians and dentists accounted for more than one-half of all health care spending for adolescents. Only 2% of adolescents were hospitalized in 1997, but they accounted for about one-fifth of all health care expenditures. The share of health expenditures paid out of pocket varied by type of service, ranging from 3% for inpatient hospital care to 51% for dental care. When covered, insurance provided substantial financial protection for families of adolescents: those with public coverage paid 8%, those with private coverage paid 32%, and those without coverage paid 61% of their health care bills out of pocket. The share of health care bills paid out of pocket would be much lower if dental care was excluded.ConclusionsOn the basis of our findings that health care expenditures for adolescents are low and that insurance coverage provides critically needed financial protection, we conclude that further expansions of public and private health insurance coverage for this population would provide significant benefits at modest additional cost. Additional efforts to improve coverage of services that are not now well-covered, such as dental care, would also be valuable.

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