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Medical Expenditure Panel Survey

Medical Expenditure Panel Survey. Karen Beauregard Steve Machlin Jeffrey Rhoades. Medical Expenditure Panel Survey. SURVEY OVERVIEW. MEPS History. 1977 National Medical Care Expenditure Survey 1987 National Medical Expenditure Survey 1996 Medical Expenditure Panel Survey.

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Medical Expenditure Panel Survey

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  1. Medical Expenditure Panel Survey Karen Beauregard Steve Machlin Jeffrey Rhoades

  2. Medical Expenditure Panel Survey SURVEY OVERVIEW

  3. MEPS History • 1977 National Medical Care Expenditure Survey • 1987 National Medical Expenditure Survey • 1996 Medical Expenditure Panel Survey

  4. Medical Expenditure Panel Survey (MEPS) Annual Survey of 15,000 households: provides national estimates of health care use, expenditures, insurance coverage, sources of payment, access to care and health care quality Permits studies of: • Distribution of expenditures and sources of payment • Role of demographics, family structure, insurance • Expenditures for specific conditions • Trends over time

  5. MEPS Survey Components • Household Component (HC) • Medical Provider Component (MPC) • Insurance Component (IC)– Link Sample • Insurance Component (IC) – List Sample

  6. MEPS-Household Component(HC) Survey Design • Sub-sample of household respondents from the previous year’s National Health Interview Survey (NHIS), sponsored by NCHS • Representative of the civilian non-institutionalized population of the US • 5 in-person interviews (CAPI) over 2 ½ year period • Person and family level data collected

  7. Oversampling 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

  8. MEPS-HC Sample Sizes YearHouseholdsPersons 1996 9,400 23,500 1997 13,500 33,000 1998-2000 10,000 24,000 2001 13,500 32,000 2002 + 15,000 37,000

  9. MEPS-HC Core Interview Content • Demographics • Charges and Payments • Health Status • Conditions • Utilization • Employment • Health Insurance

  10. MEPS Overlapping Panels(Panels 8 and 9) MEPS Household Component MEPS Panel 8 2003-2004 1/1/2003 1/1/2004 NHIS 2002 Round 1 Round 2 Round 3 Round 4 Round 5 NHIS 2003 Round 1 Round 2 Round 3 Round 4 Round 5 MEPS Panel 9 2004-2005

  11. MEPS-HC Purpose • Estimates annual health care use and expenditures • Supports distributional estimates • Tracks changes in insurance coverage and employment • Longitudinal design; linkage to NHIS

  12. Hospital stays Other hospital care Office based physician care Other medical providers Dental services Home health Prescribed medications Medical equipment and supplies MEPS-HC Utilization Data

  13. MEPS- HC Periodic Supplements • Access to care • Satisfaction with health plans & providers • Health status • Income

  14. New Supplements • Adult SAQ • Preventive Care • Enhanced Access to Care Section • Children’s Health Supplement

  15. Condition Supplements • Priority Conditions • Diabetes • Asthma • Hypertension • Ischemic Heart Disease • Arthritis • Stroke • COPD • Diabetes Care SAQ (DCS)

  16. MEPS-HC Caveats and Limitations • Sample size limitations preclude some analyses • Household respondents may not be able to report accurately certain types of information • type of health plan • detailed event information • diagnoses • limited capacity to produce state level estimates

  17. Types of MEPS-HC Files • Full-year Files - calendar year data • Point-in-time Files - snap shot first part of year

  18. 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

  19. Sub-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.

  20. Medical Expenditure Panel Survey DISSEMINATION OF INFORMATION AND DATA PRODUCTS

  21. MEPS Web-site Redesign • More User Friendly • Additional Content Added • More Powerful Databases and Search Engines • Upgraded to Meet Federal, HHS, and AHRQ Web Standards

  22. Medical Expenditure Panel Survey Methods of Dissemination • MEPS Website at www.meps.ahrq.gov • MEPS e-mail address - MEPSPD@ahrq.gov • AHRQ clearinghouse 800-358-9295 • for CD-ROMs and print publications

  23. MEPS Website www.meps.ahrq.gov • Overview of MEPS and Frequently Asked Questions (FAQs) • Staff Reports using MEPS • Findings/Statistical Briefs/Chart books • Data Tables of Estimates • Public Use Files (microdata) • MEPSnet Interactive Query Tool • Survey Methodology Reports • Survey Questionnaires and Other Collection Materials • Data product availability and ordering information • MEPS data workshop information and schedule • Mailing list and List server • Data Center Information

  24. Data User Workshops • Hands-on Workshops planned for May and September in Rockville, MD • Information will be posted on Workshops and Events section of web site • For inquiries please e-mail: Workshop06@ahrq.hhs.gov

  25. MEPS Mailing List/List Server • Mailing List/List Server • Click on “Mail List/List Server” from Web site • Both receive e-mail notices of data and publications released on the Web • List Server allows for interactive exchange of ideas and information

  26. Micro Data Files • Public Use Files (Microdata) – Available for downloading from web site (Household survey only) • Restricted Access Files (Microdata) • MEPS-HC – Available for Use at AHRQ Data Center • MEPS-IC – Available for Use at Census Research Data Centers For more information go to www.ces.census.gov

  27. Recent Data Releases • 2004 Utilization and Quality of Care • (new variables include K6 and PH2 mental health assessment tools) • 2004 Jobs File • 1996-2001 Risk Adjustment File • Link to 2003 NHIS File

  28. Recent Data Releases • 2005 First Part of Year File • 2004 Event Files • 1996-2004 Pooling File

  29. Upcoming Data Releases • 2004 Consolidated File (Use and Expenditures)-November • 2004 Condition file -November • 2002-2004 Risk adjustment File - December

  30. 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 - Rockville, Maryland • task order agreement with data contractor • combinations of both

  31. ADC Procedures • Researcher may bring data in, but not out • Researcher has access only to data needed for approved project • All tabular data will be reviewed for confidentiality before release from Center • Only approved tables can leave the Center • Center will store data files, foreign merge files, and all outputs needed for replication

  32. ADC Facilities • Secure room • Terminal connected to secure LAN • SAS, STATA, GAUSS, Stat Transfer, SUDAAN, Limdep, EQS software available, and others upon request • Limited staff support by people who know: • the data • the confidentiality issues • the software

  33. ADC Application And Review Process • Application procedures are on the MEPS web site • Submit proposal to data center coordinator • Review within 1 week for feasibility, and data availability • Institutional Review Board (IRB) review required

  34. ADC Fees • User fee of $150.00 for approved projects to cover technical assistance, simple file construction, and/or up 2 hours of programming support from data contractor • Additional programming support available from an AHRQ contractor at a cost of $80.00/hr • User fee waived for full-time students

  35. ADC Limited Remote Access • Once you have an established data center project, and have worked on site to develop and debug programs, jobs may be submitted to our Data Center Supervisor to run. Out-put will be reviewed for confidentiality and mailed to you.

  36. Confidential Data Available for ADC Projects • Linked MEPS-HC and Secondary Data (full geo-coding for 1996, 1997 and 2000-2004, FIPS codes for other years) • Selected Medical Provider Component Data • Selected State and MSA identifiers and estimation variables • 29 largest states and 10 largest MSA’s

  37. Confidential Data Available for Data Projects in ADC • Fully specified industry/occupation codes • Fully specified condition codes • Continuous poverty measure • Linked MEPS Household Component (HC) and Insurance Component (IC) data ( 96-98, 2001-excluding federal workers )

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