Medical Expenditure Panel Survey Agency for Healthcare 

Research and Quality

STATISTICAL BRIEF #116 

March 2006 

Average Annual Health Care Use and 

Expenses for Influenza, 2001–2003 Highlights 

 On average in 2001–2003, 

14.2 million persons contracted the flu. Of these, 30 

percent (4.2 million) sought 

medical treatment. 

 Medical spending to treat 

influenza totaled on average 

$850 million/year for 2001–

2003 (in 2003 dollars). 

 For 2001–2003, there was 

an annual average of 4.8 

million ambulatory care visits

for the treatment of 

influenza. 

 Children were twice as likely 

to be treated for influenza as

adults (2.4 percent of 

children versus 1.2 percent 

of adults). 

 Having a chronic condition 

did not increase the likelihood of seeking treatment 

for the flu, but average 

yearly expenditures to treat 

adults with chronic condition 

for influenza were over twice

as high as for those not 

having those conditions 

($290 versus $162). 

 In 2001–2003, the average 

mean annual expenditure 

per person to treat influenza 

(in 2003 dollars) was $52 for 

prescribed drugs, $116 for 

ambulatory visits, and $397 

for emergency room visits 

among people who used 

prescription drugs, had 

ambulatory visits, and had 

emergency room visits, 

respectively. 

Anita Soni, PhD and Steven C. Hill, PhD 

Introduction 

Influenza, also known as flu, is a viral infection in the nose, throat, 

and lungs caused by a number of different strains of the influenza 

virus. For the very young, those with chronic conditions, those with 

compromised immune systems, and the elderly, influenza often 

requires treatment by a health care professional. 

This Statistical Brief presents estimates based on the Household 

Component of the Medical Expenditure Panel Survey (MEPS-HC) on 

health care use and expenditures for influenza treatment among the 

U.S. civilian noninstitutionalized population. Average annual estimates 

(in 2003 dollars) for the period 2001–2003 are shown by age, chronic 

condition status for adults, and type of service. The brief highlights 

chronic condition status for adults because people with chronic 

conditions (such as heart disease, asthma, and diabetes) are at 

greater risk for influenza complications. Data for three years were 

combined to improve the precision of the estimates, and expenditure 

data for 2001 and 2002 were adjusted to 2003 dollars using the 

Gross Domestic Product medical care price deflator. All differences 

between estimates noted in the text are statistically significant at the 

0.05 level or better. 

Findings

Number of reported cases, total average health care use, and 

expenditures for flu

In 2001–2003, an annual average of 14.2 million persons contracted

the flu. Of these, 30 percent (4.2 million) sought medical treatment 

(figure 1). There was an annual average of 4.8 million ambulatory 

care visits for the treatment of influenza. From 2001–2003, an 

average of $850 million per year (in 2003 dollars) was spent on 

health care for influenza (estimate not shown). 

Health care use for influenza, by age and chronic condition status

During 2001–2003, an annual average of 1.5 percent of the population reported treatment of influenza (figure 2). Children were twice as 

likely to be treated for influenza as adults (2.4 percent of children 
versus 1.2 percent of adults). The probability of being treated for influenza did not vary significantly 

between adults with or without chronic conditions. 

Average mean health care expenditures for flu, by age and chronic condition status 

Among those who received treatment for influenza, $200 per person (in 2003 dollars), on average, was 

spent on treatment (figure 3). Average expenditures to treat adults (age 18 and older) with chronic 

conditions for influenza were greater than average expenditures to treat adults without chronic conditions 

for influenza ($290 versus $162). Mean expenditures for influenza did not vary significantly between 

adults and children. 

Average mean health care expenditures, by type of service for flu 

Among those with an emergency room visit related to influenza, $397 per person (in 2003 dollars), on 

average, was spent on emergency room visits (figure 4). The mean expenditure for ambulatory visits was 

$116 for those who had an influenza-related ambulatory care visit. An average of $52 was spent per 

person on the prescription medicines for influenza-related treatment among those who received 

prescription medications for influenza treatment. Over-the-counter drugs that are commonly used to treat 

the flu are not included in these estimates because information about them is not ascertained in MEPS. 

Data Source 

The estimates shown in this Statistical Brief are based on data from the MEPS 2001, 2002, and 2003 Full 

Year Consolidated Files (HC-060, HC-070, and HC-079), Medical Condition Files (HC-061, HC-069, and 

HC-078), Office-Based Medical Provider Visit Files (HC-059G, HC-067G, and HC-077G), Outpatient 

Department Visits Files (HC-059F, HC-067F, and HC-077F), Emergency Room Visit Files (HC-059E, HC067E, and HC-077E), and Prescribed Medicine Files (HC-059A, HC-067A, and HC-077A). 

Definitions 

Influenza or flu 

This brief analyzes individuals with influenza reported as a condition bothering the person and influenza 

reported in connection with reported health care utilization (e.g., a person who reported purchasing a drug 

was asked what condition the drug intended to treat) or reported disability days. The conditions reported 

by the respondent were recorded by the interviewer as verbatim text, which was then coded by 

professional coders to fully specified ICD-9-CM codes. Conditions with an ICD9 code of 487 were 

classified as influenza. 

Chronic conditions 

Chronic conditions included in the analysis for adults are diabetes, asthma, and cardiovascular disease 

and stroke. 

The indicator for cardiovascular disease and stroke was drawn from variables indicating presence of 

heart disease (coronary heart disease, angina, heart attack, stroke, or any other heart-related disease). 

For each of the conditions listed, the following question was asked: “(Have/Has) PERSON ever been told 

by a doctor or other health professional that PERSON had [condition].” 

Expenditures 

Payments from all sources for hospital inpatient care, ambulatory care provided in offices and hospital 

outpatient departments, care provided in emergency departments, as well as prescribed medicine 

purchases reported by respondents in the MEPS-HC. Sources include direct payments from individuals, 

private insurance, Medicare, Medicaid, Workers’ Compensation, and miscellaneous other sources. 

Expenditure data for 2001 and 2002 were adjusted to 2003 dollars using the Gross Domestic Product 

medical care price deflator (Bureau of Economic Analysis). 
About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 

demographic, and economic characteristics for the civilian noninstitutionalized population. It is 

cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health 

Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

References 

For a detailed description of the MEPS survey design, sample design, and methods used to minimize 

sources of nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care,

July 2003: 41(7) Supplement: III-5–III-12. 

For more information about influenza, see the following publications: 

Centers for Disease Control and Prevention. Influenza fact sheet: Key estimates about influenza and the 

influenza vaccine. Rev ed. Atlanta, Ga.: U.S. Department of Health and Human Services, Centers for 

Disease Control and Prevention: 2004. http://www.cdc.gov/flu/keyfacts.htm

Centers for Disease Control and Prevention. U.S. Influenza season summary. Atlanta, Ga.: U.S. 

Department of Health and Human Services. http://www.cdc.gov/flu/weekly/

Suggested Citation 

Soni, A. and Hill, S. C. Average Annual Health Care Use and Expenses for Influenza, 2001–2003. 

Statistical Brief #116. March 2006. Agency for Healthcare Research and Quality, Rockville, Md. 

http://www.meps.ahrq.gov/papers/st116/stat116.pdf 

∗ ∗ ∗

AHRQ welcomes questions and comments from readers of this publication who are interested in 

obtaining more information about access, cost, use, financing, and quality of health care in the United 

States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and 

tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. 

Please e-mail us at mepspd@ahrq.gov or send a letter to the address below: 

Steven B. Cohen, PhD, Director 

Center for Financing, Access, and Cost Trends 

Agency for Healthcare Research and Quality 

540 Gaither Road 

Rockville, MD 20850 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

2001–2003.

4.2 4.8

14.2

0

5

10

15

20

Persons with flu

reports

Persons with flu

treatment

Ambulatory care

visits

Number in millions

Figure 1. Average annual estimates of reported 

influenza cases, treated cases, and ambulatory

visits for influenza, 2001–2003

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

2001–2003.

2.4

1.2 1.3

1.1

1.5

0

1

2

3

4

Total Age 0-17 Age 18+ Adults with

chronic

conditions

Adults without

chronic

conditions

Percent

Figure 2. Average annual percentage of population 

reporting treatment for influenza, by age and chronic 

condition status for adults, 2001–2003
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

2001–2003.

290

162

219

174

200

0

100

200

300

400

Total Age 0-17 Age 18+ Adults with chronic

conditions

Adults without

chronic conditions

In 2003 d

ollars

Figure 3. Average annual mean expenditures per

person with expense on treatment of influenza,

by age and chronic condition status, 2001–2003

 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey,

2001–2003.

116

397

52

0

100

200

300

400

500

Ambulatory care visits Emergency room visits Prescription medications

Figure 4. Average annual mean expenditures 

per person with expense, by type of service

for influenza, 2001–2003

In 2003 d

ollars