Medical Expenditure Panel Survey

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Medical Expenditure Panel Survey

• SURVEY OVERVIEW

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MEPS History

• 1977 National Medical Care Expenditure Survey
• 1987 National Medical Expenditure Survey
• 1996 Medical Expenditure Panel Survey

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MEPS Survey Components

• The MEPS has two major components
• MEPS-HC -- Household Component
• MEPS-IC -- Insurance Component

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MEPS-HC Purpose Uses

• Estimates annual health care use, expenditures
  and insurance coverage, and tracks changes in
  these over time
• Provides estimates of expenditures and sources of
  payment by selected demographic variables
• Used for policy-related and behavioral research
  on the determinants of health care use, spending,
  and insurance coverage
• Used in micro simulation models to analyze
  alternative health care delivery proposals.

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MEPS-HC Survey Design

• Sub-sample of respondents from the previous
  years NHIS
• Representative of the civilian non-institutionaliz
  ed population of the US
• Five in-person interviews over 2 ½ year period
  using CAPI.
• Interviews average 90 minutes with a range of one
  to four hours

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MEPS-HC Survey Design -- Oversampling

• Oversampling improves the precision of estimates
  for specific subgroups
• Blacks and Hispanics have been oversampled every
  year with an additional over sampling of blacks
  in 2004
• Low income and Asians oversampled in 2002 and
  beyond

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MEPS-HC Sample Sizes

• Year Families Persons
• 1996 8,655 21,571
• 1997 13,087
  32,636
• 1998 9,023
  22,953
• 1999 9,354
  23,565
• 2000 9,515
  23,839
• 2001 12,852
  32,122
• 2002 14,828
  37,418
• 2003 12,860
  32,681
• 2004 13,018
  32,737
• 2005 12,810
  32,320

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MEPS Panel Design Data Reference Periods
N is equal to the number of people with a
positive person weight on the file.
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MEPS-HC Core Interview Content

• Demographics
• Charges and Payments
• Health Status
• Conditions
• Utilization
• Employment
• Health Insurance

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MEPS- HC Supplemental CAPI Sections

• Sections asked in rounds 2 and 4
• Access to care
• Child preventive health
• Satisfaction with health plans providers
• Sections asked in rounds 3 and 5
• Assets (round 5 only)
• Income
• Preventive Care
• Priority conditions

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MEPS-HC Supplemental Paper Questionnaires

• Diabetes Care SAQ
• Given once a year to each person identified as
  having diabetes
• Includes questions about diabetes related tests
  and managing diabetes
• Adult SAQ
• Given once a year to each adult 18 years old and
  older
• Focus is on information that needs to be self
  reported such as self assessments,
  height/weight, opinions about health care issues
  and quality of care measures

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Types of MEPS-HC Files

• Full-year Files - calendar year data
• Point-in-time Files - snap shot first part of
  year
• MEPS/NHIS Link File
• Longitudinal Data File
• MEPS HC-036 1996-2005 Pooled Estimation File

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Levels of MEPS-HC Public Use Files

• Person Level - detailed person information
• Event Level - detailed event level information
• Condition Level - detailed condition information
• Job Level - detailed job information

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MEPS-HC Caveats and Limitations

• Sample size limitations preclude some analyses
• Typically, one respondent provides data for the
  entire household
• Household respondents may not be able to report
  accurately certain types of information
• type of health plan
• detailed event information
• diagnoses

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MEPS-IC (Insurance Component)

• An independent survey of employers and unions not
  linked to the household survey
• The sample contains information from about 45,000
  establishments and supports national and
  state-level estimates for all 50 states.
• Employer-sponsored health insurance measures
• Availability
• Enrollment
• Benefit and payment provisions
• Cost

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MEPS Publications

• Statistical Briefs Easy-to-read, concise
  graphical summaries of MEPS data
• Research Findings and Highlights Tables and
  summaries of descriptive statistics
• Methodology Reports Detailed information on MEPS
  sample design and survey methods
• Chartbooks Policy-sensitive topics in an
  accessible question-and-answer format
• Working Papers Preliminary analyses of
  methodological and technical issues by AHRQ staff
  
• Research in Action Analyses using research
  results from AHRQ-sponsored studies, including
  MEPS data

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AHRQ Data Center (ADC)

• Provides researchers access to non-public use
  MEPS data (except directly identifiable
  information)
• Mode of data analysis
• on secure LAN at AHRQ
• task order agreement with data contractor
• combinations of both

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Examples of Confidential Data Available for ADC
Projects

• Linked MEPS-HC and Secondary Data
• Full geo-coding for 1996, 1997 and 2000-2005.
  FIPS codes for other years
• Fully specified industry/occupation and condition
  codes
• Selected State and MSA identifiers and estimation
  variables
• 30 largest states and 10 largest MSAs