Just one percent of the population accounted for 22% of all spending on healthcare in the United States in 2009, according to a new report.

Researchers at the US Agency for Healthcare Research and Quality (AHRQ; Rockville, MD, USA) found that this percentage was slightly higher than the 2008 figure of 20%, but was still smaller than it was in 1996, when the top one percent of healthcare spenders accounted for 28% of total healthcare expenditures. But one fact remained constant - the top-spending 5% accounted for more than half of US medical spending, with the average per capita spending for each person in that group accounting for more than half of the national medical spending.

However, if only a small percentage of the US population accounts for a disproportionately large share of total medical spending, a larger percentage spent a disproportionately small amount. The study found that half the population accounted for less than 3% of healthcare spending, with those in the top-spending 10% more likely to be 45 and older. Although the elderly (65 and older) account for only 13% of the current overall population, they represent 43% of individuals in the top 10% of healthcare spending.

Individuals identified as Hispanic and black non-Hispanic single race were disproportionately represented among the population in the lower half of the distribution, based on health care spending. While Hispanics represented 16% of the overall population in 2009, they represented 24.5% of those individuals who remained in the bottom 50% of spenders. For those individuals who remained in the top 10% of spenders, Hispanics represented only 6.7% of the population; conversely, those in the top 10% of spenders more likely to be non-Hispanic whites and other races (77.6%), relative to their representation in the overall population (67.2%).

“Relative to the overall population, those who remained in the top decile of spenders were more likely to be in fair or poor health, elderly, female, non-Hispanic whites and those with public-only coverage,” concluded study authors Steven Cohen, PhD, and William Yu, MA. “Those who remained in the bottom half of spenders were more likely to be in excellent health, children and young adults, men, Hispanics, and the uninsured.”

The data was extracted from the 2008 and 2009 Medical Expenditure Panel Survey (MEPS), published on January 13, 2012, which provides detailed estimates on healthcare expenditures over time, including payments from individuals, private health insurers, Medicare, and Medicaid, and is made public to all.

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