This section presents statistics on health expenditures and insurance coverage; medical personnel; hospitals; nursing homes and other care facilities; incidence of acute and chronic conditions; nutritional intake of the population; per capita food consumption; and Federal food programs. Summary statistics showing recent trends on health care and discussions of selected health issues are published annually by the U.S. National Center for Health Statistics (NCHS) in Health, United States. Data on national health expenditures, medical costs, and insurance coverage are compiled by the U.S. Health Care Financing Administration (HCFA), and appear in the Health Care Financing Review, issued quarterly. Statistics on health personnel and inpatient and outpatient facilities are collected by NCHS and are published in series 14 of Vital and Health Statistics. Statistics on hospitals are published annually by the American Hospital Association, Chicago, IL, in Hospital Statistics. Primary sources for data on nutrition and Federal food programs are the quarterly National Food Review and the annual Agricultural Statistics, both issued by the U.S. Department of Agriculture. In addition, NCHS conducts periodic surveys of nutrient levels in the population and clinical signs of malnutrition. National health expenditures.—The HCFA compiles estimates of national health expenditures (NHE) to measure spending for health care in the U.S. The NHE accounts are structured to show spending by type of expenditure (i.e., hospital care, physician care, dental care, other professional care, drugs and medical sundries, medical durable equipment, nursing home care and other personal health expenditures, plus non-personal health expenditures for such items as public health, research, construction of medical facilities, and administration) and by source of funding (e.g., private health insurance, direct payments, and a range of public programs including Medicare, Medicaid and Veterans Administration (VA)). In all cases except private insurance (HCFA conducts its own survey of part of the health insurance industry), data used to estimate health expenditures come from existing sources which are tabulated for other purposes. The type of expenditure estimates rely upon statistics produced by such groups as the American Hospital Association, the Internal Revenue Service, the Department of Commerce, and the Department of Health and Human Services (HHS). Source of funding estimates are constructed using administrative and statistical records from: the Medicare and Medicaid programs, the Department of Defense and VA medical programs, the Social Security Administration, Census Bureau's Governmental Finances, State and local governments, and other HHS agencies. Detailed descriptions of sources and methods, along with the most recent analysis of health care expenditure estimates, are published in the Health Care Financing Review's annual article on national health expenditures. Health resources.—Hospital statistics based on data from the American Hospital Association's yearly survey are published annually in Hospital Statistics, and cover all hospitals accepted for registration by the Association. To be accepted for registration, a hospital must meet certain requirements relating to number of beds, construction, equipment, medical and nursing staff, patient care, clinical records, surgical and obstetrical facilities, diagnostic and treatment facilities, laboratory services, etc. Data obtained from NCHS cover all U.S. hospitals which meet certain criteria for inclusion. They are published in Vital and Health Statistics reports, series 14. In these reports, a hospital is defined as a facility with at least six inpatient beds that is licensed as a hospital by a State, or is operated as a hospital by a Federal or State agency. Statistics on the demographic characteristics of persons employed in the health occupations are based on data compiled by the U.S. Bureau of Labor Statistics and reported in Employment and earnings (monthly). Data based on sample surveys of health personnel and utilization of health facilities providing long-term care, ambulatory care, and hospital care are presented in NCHS series 13 and series 14, Health Resources Utilization Data and Manpower and Facilities Data. Statistics on patient visits to health care providers, as reported in health interviews, appear in NCHS series 10, Health Interview Survey. The Health Care Financing Administration's Health Care Financing Review, Health Care Financing Program Statistics and Notes series present data for hospitals and nursing homes as well as extended care facilities and home health agencies. These data are based on records of the Federal Health Insurance for the Aged and Disabled program (Medicare) and differ from those of other sources because they are limited to facilities meeting Federal eligibility standards for participation in Medicare. Data on patients in hospitals for the mentally ill and on mental health facilities are collected by the National Institute of Mental Health (NIMH) and appear in the Mental Health Statistics reports, series CN, and the Mental Health Statistical Note series. Institutional population data based on the decennial censuses of the population include information on persons in hospitals, in homes for the aged and dependent, and in other group quarters (see tables 72 and 73). Disability and illness.—General health statistics, including morbidity, disability, injuries, preventive care, and findings from physiological and psychological testing, are collected by NCHS in its National Health Interview Survey and its National Health and Nutrition Examination Surveys and appear in Vital and Health Statistics, series 10 and 11, respectively. Morbidity data for members of the Armed Services are prepared and published by the Departments of the Army, Navy, and Air Force. The Department of Labor compiles statistics on industrial injuries (see Section 14). Annual incidence data on notifiable diseases are compiled by the Public Health Service (PHS) at its Centers for Disease Control in Atlanta, Georgia, and are published as a supplement to its Morbidity and Mortality Weekly Report. The list of diseases is revised annually and includes those which, by mutual agreement of the States and PHS, are communicable diseases of national importance. Nutrition.—Statistics on annual per capita consumption of food and its nutrient value are estimated by the U.S. Department of Agriculture and published in National Food Review. Historical data can be found in Food Consumption, Prices, and Expenditures, issued annually. Data on the Federally Funded Food Distribution Program for Needy Families and Children, the National School Lunch Program, the Special Milk Program, and the Food Stamp Program are published annually in Agricultural Statistics. Statistical reliability.—For discussion of statistical collection, estimation, and sampling procedures and measures of statistical reliability applicable to data from NCHS and the Health Care Financing Administration, see Appendix III. Historical statistics.—Tabular headnotes provide cross-references, where applicable, to Historical Statistics of the United States, Colonial Times to 1970. See Appendix I. No. 142. National Health Expenditures: 1960 To 1983 I960 1965 1970. 1971.. 1972 1973. 1974.. 1975. 1976 1977 1978 Total (bil. dol) Per capita (dol) Direct patient Total (bil. dol.) Percent of total private Insurance premiums * (bil. dol) Total (bil dol.) Per- health Medical payments Medicare (bil. dol.) 1979.. 1960. 1961.. 1962. 1983 1.049 1.197 1.337 1.459 9 7 46 4 39 1 34 9 37 2 X Not applicable 'Includes medical research and medical facilities construction • r.wp r~ table 714 "includes other sources of funds not shown separate!, . See footnote 3N^h£r0??,naUoTM!1 P"**** — Programs, not shown separately noIe 3- "**> 143 'Includes other Source: U.S. Health Care Financing Administration. Hatltti Ctre Frwnong flevw,, Wmter 1984 National Health Expenditures 97 No. 143. NATIONAL HEALTH EXPENDITURES, BY TYPE: 1970 TO 1983 Change from prior year shown, except as noted. For explanation of average annual percent change, see Guide to Tabular Presentation Change from 1965. ' Covers insurance benefits and amount retained by insurance companies for expenses, additions to reserves, and profits (net cost of insurance). • Represents expenditures for benefits and administrative cost from Federal hospital and medical insurance trust funds under old-age, survivors, disability, and health insurance programs, see text, p. 351. S Includes medical benefits paid under public law by private insurance carriers and self-insurers. Payments made directly to suppliers of medical care. (Primarily Medicaid.) 7 Expenditures not offset by other revenues. & Covers expenditures for Alcohol, Drug Abuse, and Mental Health Administration; Indian Health Service; school health and other programs. Source: U.S. Health Care Financing Administration, Health Care Financing Review, Winter 1984. No. 144. NATIONAL HEALTH EXPENDITURES, BY OBJECT: 1970 TO 1983 (See also Historical Statistics, Colonial Times to 1970, series B 221-235) Includes services of registered and practical nurses in private duty. visiting nurses, podiatrists, physical therapists, clinical psychologists, chiropractors, naturopaths, and Christian Science practitioners. 2 Includes tees of optometrists and expenditures for hearing aids, orthopedic appliances, artifical limbs, crutches, wheelchairs, etc. Administrative expenses of federally financed health programs. Source: U.S. Health Care Financing Administration, Health Care Financing Review, Winter 1984. No. 145. Health Services And Supplies—Per Capita National And Private Consumer Expenditures, By Object: 1970 To 1983 [In dollars, except percent. Based on Bureau of the Census data for total U.S. population as of July 1, including Armed Forces and Federal employees abroad and civilian population of outlying areas. Excludes research and construction. See also Historical Statistics. Colonial Times to 1970. series B 222-232) 1 Change from prior year shown; for 1970 from 1965. For explanation of average annual percent change, see Guide to Tabular Presentation. 2See footnotes for corresponding objects in table 144. No. 146. Personal Health Care—Third Party Payments And Private Consumer [In millions of dollars, except percent] 1 See headnote, table 147. z Includes expenditures not shown separately Excludes net cost of insurance. No. 147. Personal Health Care Expenditures, By Object And Source Of Payment: 1983 [In millions of dollars, except as Indicated. Covers all expenditures for health services and supplies, except net cost of insurance and administration, government public health activities, and expenditures of philanthropic agencies tor fund raismg activities] 1**,*4« 68.823 49,71* 21.232 5.553 21,616 5.191 14.878 1.838 - Represents zero 'For basis of per capita figures, see headnote. table 145 ■Covers direct patient payments, private health insurance, and philanthropy and industry Source of tables 145-147: U.S. Heatth Care Financing Administration. Health Care Financing Review. Winter 1984 No. 148. GOVERNMENT EXPENDITURES FOR HEALTH SERVICES AND SUPPLIES: 1980 AND 1983 [In millions of dollars, except percent. Excludes medical research and construction] - Represents zero. Includes other items not shown separately. Covers hospital and medical insurance payments and administrative costs under old-age, survivors, disability and health insurance program. Covers Medicaid and other medical public assistance. Includes funds paid into Medicare trust fund by States to cover premiums for public assistance recipients and medically indigent persons. Includes care for retirees and military dependents. Medical benefits. Source: U.S. Health Care Financing Administration, Health Care Financing Review, Winter 1984. No. 149. FEDERAL OUTLAYS FOR HEALTH, BY TYPE OF PROGRAM: 1970 TO 1984 (For years ending June 30 except, beginning 1980, ending September 30) - Represents zero. NA Not available. Z Less than 50 cents. Based on Bureau of the Census estimated resident population as of July. ? Adjusted for premiums and collections. Source: U.S. Office of Management and Budget, The Budget of the United States Government, annual and unpublished document, "Federal Government Finances," February 1984 edition. No. 150. BENEFIT EXPENDITURES OF PRIVATE HEALTH INSURANCE ORGANIZATIONS: 1975 TO 1982 [In millions of dollars. For financial data on private health insurance organizations, see table 866] Physi- Dental care and other Total ..........................********** 30,072 35,471 40,013 45,044 50,176 58,619 66,773 76,551 Blue Cross-Blue Shield ................ 14,192 16,227 17,626 19,465 21,724 25,466 29,209 32,357 Insurance companies.... 13,157 15,493 17,206 19,057 20.145 21,678 23,266 26,198 Independent plans ....... 2,723 3,751 8,307 11,475 14,298 17,996 Source: U.S. Health Care Financing Administration, Health Care Financing Review, Winter 1984, and unpublished data. |