How Much Money Is Spent on Health Care for Kids, Where Does It Go?


Media Advisory: To contact corresponding author Joseph L. Dieleman, Ph.D., email Kayla Albrecht at or call 206-897-3792.

Related material: This article is being released to coincide with publication in JAMA of “U.S. Spending on Personal Health Care and Public Health, 1996-2013,” also by Joseph L. Dieleman, Ph.D., and the editorial, “How Can the United States Spend Its Health Care Dollars Better?” by Ezekiel J. Emanuel, M.D., Ph.D., of the University of Pennsylvania, Philadelphia. Also available in JAMA Pediatrics is the editorial, “Spending on Children’s Health Care in the United States: Accomplishments and Challenges in Financing Health Services for Children,” by Rachel L. Garfield, PhD., of the Kaiser Family Foundation, Washington, D.C. All are available on the For The Media website.

Related audio material: An author audio interview is available for preview on the For The Media website. The podcast will be live when the embargo lifts on the JAMA Pediatrics website.

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JAMA Pediatrics

Health care spending on children grew 56 percent between 1996 and 2013, with the most money spent in 2013 on inpatient well-newborn care, attention deficit/hyperactivity disorder (ADHD) and well-dental care, according to an article published online by JAMA Pediatrics.

Joseph L. Dieleman, Ph.D., of the University of Washington, Seattle, and coauthors used the Institute for Health Metrics and Evaluation Disease Expenditure 2013 project database to estimate health care spending. Annual estimates were done for each year from 1996 through 2013 and estimates were reported using inflation-adjusted 2015 dollars.

Authors report:

  • Spending on children’s health care increased from $149.6 billion in 1996 to $233.5 billion in 2013, driven by growth in ambulatory and inpatient spending and growth in well-newborn and ADHD care spending.
  • In 2013, the three conditions with the most health care spending were inpatient well-newborn care ($27.9 billion), ADHD ($20.6 billion) and well-dental care ($18.2 billion). Asthma had the fourth largest level of spending at $9 billion.
  • Over time, health care spending per child has increased from $1,915 in 1996 to $2,777 in 2013.

The study has some limitations, including that it reflects only direct health care spending and does not account for indirect costs such as child care costs and parents’ lost wages.

“The next step should be analyzing the factors driving increased health care spending and determining whether changes in particular subcategories of spending have been associated with improvements in processes or outcomes. It is crucial to understand whether spending increases have been appropriate or misguided and how we might target spending increases and reductions now and in the future,” the article concludes.

(JAMA Pediatr. Published online December 27, 2016. doi:10.1001/jamapediatrics.2016.4086; available pre-embargo at the For The Media website.)

Editor’s Note: The article contains funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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