medical expenditure panel survey karen beauregard steve machlin jeffrey rhoades
TRANSCRIPT
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Medical Expenditure Panel SurveyMedical Expenditure Panel Survey
Karen BeauregardKaren BeauregardSteve MachlinSteve Machlin
Jeffrey RhoadesJeffrey Rhoades
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Medical Expenditure Panel SurveyMedical Expenditure Panel Survey
SURVEY OVERVIEWSURVEY OVERVIEW
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MEPS HistoryMEPS History
1977 National Medical Care Expenditure 1977 National Medical Care Expenditure SurveySurvey
1987 National Medical Expenditure Survey1987 National Medical Expenditure Survey
1996 Medical Expenditure Panel Survey1996 Medical Expenditure Panel Survey
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Medical Expenditure Panel Medical Expenditure Panel Survey (MEPS)Survey (MEPS)
Annual Survey of 15,000 households:Annual Survey of 15,000 households: provides national estimates of health care use, provides national estimates of health care use, expenditures, insurance coverage, sources of payment, expenditures, insurance coverage, sources of payment, access to care and health care qualityaccess to care and health care quality
Permits studies of:Permits studies of: Distribution of expenditures and sources of paymentDistribution of expenditures and sources of payment Role of demographics, family structure, insuranceRole of demographics, family structure, insurance Expenditures for specific conditionsExpenditures for specific conditions Trends over timeTrends over time
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MEPS Survey ComponentsMEPS Survey Components
Household Component (HC)Household Component (HC)
– Medical Provider Component (MPC)Medical Provider Component (MPC)
– Insurance Component (IC)– Link SampleInsurance Component (IC)– Link Sample
Insurance Component (IC) – List SampleInsurance Component (IC) – List Sample
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MEPS-Household Component(HC) Survey Design
Sub-sample of household respondents Sub-sample of household respondents from the previous year’s National Health from the previous year’s National Health Interview Survey (NHIS), sponsored by Interview Survey (NHIS), sponsored by NCHSNCHS
Representative of the civilian non-Representative of the civilian non-institutionalized population of the USinstitutionalized population of the US
5 in-person interviews (CAPI) over 2 ½ year 5 in-person interviews (CAPI) over 2 ½ year periodperiod
Person and family level data collectedPerson and family level data collected
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Oversampling in MEPSOversampling in MEPS
Every year: Blacks and Hispanics– Carryover from NHIS
1997: Selected subpopulations– Functionally impaired adults– Children with activity limitations– Adults 18-64 predicted to have high medical expenditures– Low income– Adults with other impairments
2002 and beyond:– Asians – Low income– Additional over sampling of blacks in 2004
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MEPS-HC Sample SizesMEPS-HC Sample Sizes
YearYear HouseholdsHouseholds PersonsPersons
19961996 9,400 9,400 23,500 23,500
19971997 13,500 33,00013,500 33,000
1998-20001998-2000 10,00010,000 24,000 24,000
20012001 13,50013,500 32,000 32,000
20022002 ++ 15,00015,000 37,000 37,000
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MEPS-HC MEPS-HC Core Interview ContentCore Interview Content
DemographicsDemographics Charges and PaymentsCharges and Payments Health StatusHealth Status ConditionsConditions Utilization Utilization EmploymentEmployment Health InsuranceHealth Insurance
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Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
Panel 5
Round 3
Round 4
Round 5
Panel 6
Round 1
Round 2
Round 3
Round 4
Round 5
Panel 7
Round 1
Round 2
Round 3
Round 4
Round 5
Panel 8
Round 1
Round 2
Round 3
Round 4
Round 5
Panel 9
Round 1
Round 2
Round 3
Sample Size
2001 2002 2003 2004
N= 32,122 N=37,418 N=32,681 N=32,737
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 Overlapping PanelsMEPS Overlapping Panels(Panels 8 and 9)(Panels 8 and 9)
MEPS Household Component MEPS Panel 8
2003-2004
Round 2
Round 3 Round 4 Round 5
Round 1 Round 2 Round 3
MEPS Panel 92004-2005
1/1/2003 1/1/2004
Round 1
NHISNHIS20022002
NHISNHIS20032003 Round 4 Round 5
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MEPS-HC PurposeMEPS-HC Purpose
Estimates annual health care use and Estimates annual health care use and expendituresexpenditures
Supports distributional estimatesSupports distributional estimates Tracks changes in insurance Tracks changes in insurance
coverage and employmentcoverage and employment Longitudinal design; linkage to NHISLongitudinal design; linkage to NHIS
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MEPS-HC Utilization DataMEPS-HC Utilization Data
Hospital staysHospital stays Other hospital careOther hospital care Office based Office based
physician carephysician care Other medical Other medical
providersproviders
Dental servicesDental services Home healthHome health Prescribed Prescribed
medicationsmedications Medical equipment Medical equipment
and suppliesand supplies
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MEPS- HC Periodic MEPS- HC Periodic SupplementsSupplements
Access to careAccess to care Satisfaction with health Satisfaction with health
plans & providersplans & providers Health statusHealth status Income Income
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New SupplementsNew Supplements
Adult SAQAdult SAQ Preventive CarePreventive Care Enhanced Access to Care Enhanced Access to Care
SectionSection Children’s Health Children’s Health
Supplement Supplement
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Condition SupplementsCondition Supplements
Priority ConditionsPriority Conditions– DiabetesDiabetes– AsthmaAsthma– HypertensionHypertension– Ischemic Heart DiseaseIschemic Heart Disease– ArthritisArthritis– StrokeStroke– COPDCOPD
Diabetes Care SAQ (DCS)Diabetes Care SAQ (DCS)
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MEPS-HC Caveats and MEPS-HC Caveats and LimitationsLimitations
Sample size limitations preclude some analysesSample size limitations preclude some analyses Household respondents may not be able to report Household respondents may not be able to report
accurately certain types of informationaccurately certain types of information– type of health plantype of health plan– detailed event informationdetailed event information– diagnosesdiagnoses– limited capacity to produce state level estimateslimited capacity to produce state level estimates
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Types of MEPS-HC FilesTypes of MEPS-HC Files
Full-year Files - calendar year dataFull-year Files - calendar year data
Point-in-time Files - snap shot first Point-in-time Files - snap shot first part of yearpart of year
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Levels of MEPS-HC Public Levels of MEPS-HC Public Use FilesUse Files
Person Level - detailed person Person Level - detailed person informationinformation
Event Level - detailed event level Event Level - detailed event level informationinformation
Condition Level - detailed condition Condition Level - detailed condition informationinformation
Job Level - detailed job informationJob Level - detailed job information
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Sub-national AnalysisSub-national Analysis
Supports state estimates: Direct state level estimates of cost, coverage and use for the largest states.
Supports metro area estimates: Direct MSA level estimates of cost, coverage and use for the largest metropolitan areas.
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Medical Expenditure Panel SurveyMedical Expenditure Panel Survey
DISSEMINATION OF DISSEMINATION OF INFORMATION AND DATA INFORMATION AND DATA
PRODUCTSPRODUCTS
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MEPS Web-site RedesignMEPS Web-site Redesign
More User FriendlyMore User Friendly Additional Content AddedAdditional Content Added More Powerful Databases and Search More Powerful Databases and Search
EnginesEngines Upgraded to Meet Federal, HHS, and Upgraded to Meet Federal, HHS, and
AHRQ Web StandardsAHRQ Web Standards
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Medical Expenditure Panel Survey Medical Expenditure Panel Survey Methods of Dissemination Methods of Dissemination
MEPS Website at MEPS Website at www.meps.ahrq.govwww.meps.ahrq.gov
MEPS e-mail address - MEPS e-mail address - [email protected]@ahrq.gov
AHRQ clearinghouse AHRQ clearinghouse 800-358-9295800-358-9295– for CD-ROMs and print publicationsfor CD-ROMs and print publications
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MEPS Website MEPS Website www.meps.ahrq.govwww.meps.ahrq.gov
Overview of MEPS and Frequently Asked Questions (FAQs)Overview of MEPS and Frequently Asked Questions (FAQs) Staff Reports using MEPS Staff Reports using MEPS
Findings/Statistical Briefs/Chart booksFindings/Statistical Briefs/Chart books Data Tables of EstimatesData Tables of Estimates Public Use Files (microdata) Public Use Files (microdata) MEPSnet Interactive Query ToolMEPSnet Interactive Query Tool Survey Methodology Reports Survey Methodology Reports Survey Questionnaires and Other Collection MaterialsSurvey Questionnaires and Other Collection Materials Data product availability and ordering informationData product availability and ordering information MEPS data workshop information and schedule MEPS data workshop information and schedule Mailing list and List serverMailing list and List server Data Center InformationData Center Information
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Data User WorkshopsData User Workshops
Hands-on Workshops planned for May and Hands-on Workshops planned for May and September in Rockville, MDSeptember in Rockville, MD
Information will be posted on Workshops and Information will be posted on Workshops and Events section of web siteEvents section of web site
For inquiries please e-mail: For inquiries please e-mail: [email protected]@ahrq.hhs.gov
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MEPS Mailing List/List MEPS Mailing List/List ServerServer
Mailing List/List ServerMailing List/List Server Click on “Mail List/List Server” from Web Click on “Mail List/List Server” from Web
site site Both receive e-mail notices of data and Both receive e-mail notices of data and
publications released on the Webpublications released on the Web List Server allows for interactive exchange List Server allows for interactive exchange
of ideas and informationof ideas and information
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Micro Data FilesMicro Data Files
Public Use Files (Microdata) – Available for Public Use Files (Microdata) – Available for downloading from web site (Household survey downloading from web site (Household survey only)only)
Restricted Access Files (Microdata) Restricted Access Files (Microdata) – MEPS-HC – Available for Use at AHRQ Data CenterMEPS-HC – Available for Use at AHRQ Data Center– MEPS-IC – Available for Use at Census Research Data MEPS-IC – Available for Use at Census Research Data
CentersCentersFor more information go to www.ces.census.govFor more information go to www.ces.census.gov
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Recent Data ReleasesRecent Data Releases
2004 Utilization and Quality of Care2004 Utilization and Quality of Care– (new variables include K6 and PH2 mental health assessment tools)(new variables include K6 and PH2 mental health assessment tools)
2004 Jobs File2004 Jobs File
1996-2001 Risk Adjustment File1996-2001 Risk Adjustment File
Link to 2003 NHIS FileLink to 2003 NHIS File
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Recent Data ReleasesRecent Data Releases
2005 First Part of Year File 2005 First Part of Year File
2004 Event Files 2004 Event Files
1996-2004 Pooling File 1996-2004 Pooling File
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Upcoming Data ReleasesUpcoming Data Releases
2004 Consolidated File (Use and 2004 Consolidated File (Use and Expenditures)-NovemberExpenditures)-November
2004 Condition file -November2004 Condition file -November
2002-2004 Risk adjustment File - December2002-2004 Risk adjustment File - December
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AHRQ Data Center (ADC)AHRQ Data Center (ADC)
Provides researchers access to non-public use Provides researchers access to non-public use MEPS data (except directly identifiable information);MEPS data (except directly identifiable information);
Mode of data analysis Mode of data analysis
– on secure LAN at AHRQ - Rockville, Maryland on secure LAN at AHRQ - Rockville, Maryland
– task order agreement with data contractor task order agreement with data contractor
– combinations of bothcombinations of both
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ADC ProceduresADC Procedures
Researcher may bring data in, but not outResearcher may bring data in, but not out Researcher has access only to data needed for approved Researcher has access only to data needed for approved
projectproject All tabular data will be reviewed for confidentiality before All tabular data will be reviewed for confidentiality before
release from Centerrelease from Center Only approved tables can leave the CenterOnly approved tables can leave the Center Center will store data files, foreign merge files, and all Center will store data files, foreign merge files, and all
outputs needed for replicationoutputs needed for replication
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ADC FacilitiesADC Facilities Secure roomSecure room Terminal connected to secure LANTerminal connected to secure LAN SAS, STATA, GAUSS, Stat Transfer, SUDAAN, Limdep, SAS, STATA, GAUSS, Stat Transfer, SUDAAN, Limdep,
EQS software available, and others upon request EQS software available, and others upon request Limited staff support by people who know:Limited staff support by people who know:
– the datathe data– the confidentiality issuesthe confidentiality issues– the softwarethe software
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ADC Application ADC Application And Review ProcessAnd Review Process
Application procedures are on the Application procedures are on the MEPS web siteMEPS web site
Submit proposal to data center Submit proposal to data center coordinatorcoordinator
Review within 1 week for feasibility, Review within 1 week for feasibility, and data availabilityand data availability
Institutional Review Board (IRB) Institutional Review Board (IRB) review requiredreview required
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ADC FeesADC Fees
User fee of $150.00 for approved projects to User fee of $150.00 for approved projects to cover technical assistance, simple file cover technical assistance, simple file construction, and/or up 2 hours of construction, and/or up 2 hours of programming support from data contractorprogramming support from data contractor
Additional programming support available Additional programming support available from an AHRQ contractor at a cost of $80.00/hrfrom an AHRQ contractor at a cost of $80.00/hr
User fee waived for full-time studentsUser fee waived for full-time students
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ADC Limited Remote ADC Limited Remote AccessAccess
Once you have an established data Once you have an established data center project, and have worked on site center project, and have worked on site to develop and debug programs, jobs to develop and debug programs, jobs may be submitted to our Data Center may be submitted to our Data Center Supervisor to run. Out-put will be Supervisor to run. Out-put will be reviewed for confidentiality and mailed reviewed for confidentiality and mailed to you.to you.
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Confidential Data Confidential Data Available for ADC ProjectsAvailable for ADC Projects
Linked MEPS-HC and Secondary Data (full Linked MEPS-HC and Secondary Data (full geo-coding for 1996, 1997 and 2000-2004, geo-coding for 1996, 1997 and 2000-2004, FIPS codes for other years)FIPS codes for other years)
Selected Medical Provider Component DataSelected Medical Provider Component Data
Selected State and MSA identifiers and Selected State and MSA identifiers and estimation variablesestimation variables– 29 largest states and 10 largest MSA’s29 largest states and 10 largest MSA’s
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Confidential Data Available for Confidential Data Available for Data Projects in ADCData Projects in ADC
Fully specified industry/occupation codesFully specified industry/occupation codes
Fully specified condition codesFully specified condition codes
Continuous poverty measure Continuous poverty measure
Linked MEPS Household Component (HC) and Linked MEPS Household Component (HC) and Insurance Component (IC) data ( 96-98, 2001-Insurance Component (IC) data ( 96-98, 2001-excluding federal workers )excluding federal workers )