Young adults ages 19 to 24 tend to have low overall out-of-pocket health care costs, but they sometimes run up big ambulance bills.

The Deloitte Center for Health Solutions, Washington, and the Deloitte Center for Financial Services, have broken out ambulance expenditures by age in a report they developed to look at total U.S. health care expenditures, including out-of-pocket expenditures on items such as nutritional supplements, health magazines and home health care.

The official government health care cost estimates tend to leave out many of those costs, Deloitte analysts say.

The analysts combined federal National Health Expenditure Accounts data with results from a telephone survey of 1,008 U.S. adults.

Deloitte found that, in 2009, consumers spent about $363 billion on health care services and products that were not included in the official government health expenditure statistics.

One table in the report gives per-capita out-of-pocket expenditures for various categories of expenditures broken out by the consumer’s age.

Per-capita expenditures are highest in most categories for consumers ages 65 and older and, in a few, for children ages 0 to 18.

In the hospital care category, for example, people ages 19 to 24 paid about $50 per capita out of pocket; people ages 65 and older paid an average of about $111.

In the nutritional supplement category, people ages 25 to 44 were the obvious big spenders among adults ages 19 to 64: They spent about $122 in 2009 out of pocket on nutritional supplements, compared with an average of $69 for people ages 19 to 24 and an average of $95 for people ages 45 to 64.

In a much smaller category, the ambulance services category, adults ages 19 to 24 were the big spenders. They spent $3.67 per capita on ambulances. Children used $1.88 in ambulance services, adults ages 25 to 44 spent $2.72, and adults ages 45 to 64 spent $2.81. Adults 65 and older spent just 83 cents out of pocket on ambulance rides.

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