HealthDay News — Health care expenditure in the United States remains unevenly distributed, with 1% of the population accounting for approximately 20% of expenditure in 2008 and 2009, according to a January statistical brief published by the Agency for Healthcare Research and Quality (AHRQ).

Although disparity is high, it is smaller than it was in the last AHRQ report in 1996, in which the top 1% of health-care spenders accounted for 28% of total health-care expenditures.

Data come from the Medical Expenditure Panel Survey, which bases health-care expenditure estimates on payment records from individuals, private health insurers and Medicare and Medicaid, that were made to all health-care providers and pharmacies.

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The report reveals that the top-spending 5% of the U.S. population accounted for more than half of the nation’s medical spending in 2009; whereas, the 50% of the population that spent the least on healthcare, accounted for less than 3% of all health-care spending that year.

Compared with the general population, those in the top 10% of health-care spenders were more likely to report that they were in “poor” or “fair” health, elderly, female, non-Hispanic white and that they had public-only healthcare coverage.

Those who remained in the bottom half of health-care spenders were more likely to report “excellent” health status, be children and young adults, male, Hispanic and uninsured.

The top spending 10% were also more likely to be aged 45 years and older, the report revealed. Although elderly people aged 65 years and older only account for 13% of the population, they represented 43% of people in the top-spending healthcare decile. 

Among individuals younger than 65 years, 15.5% were uninsured for all of 2009, including 25.9% of spenders in the bottom half for both 2008 and 2009, and 3.6% of those in the top decile of spenders in both 2008 and 2009.

Total U.S. healthcare spending totaled $1.26 trillion in 2009, according to the report.

Cohen SB, Yu W. “Medical Expenditure Panel Survey.” Statistical Brief #354. January 2012. Agency for Healthcare Research and Quality, Rockville, Md.