Medical Expenditure Panel Survey

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Medical Expenditure Panel Survey

• Karen Beauregard
• Steve Machlin
• Jeffrey Rhoades

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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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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

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MEPS Survey Components

• Household Component (HC)
• Medical Provider Component (MPC)
• Insurance Component (IC) Link Sample
• Insurance Component (IC) List Sample

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MEPS-Household Component(HC) Survey Design

• Sub-sample of household respondents from the
  previous years National Health Interview Survey
  (NHIS), sponsored by NCHS
• Representative of the civilian non-institutionaliz
  ed population of the US
• 5 in-person interviews (CAPI) over 2 ½ year
  period
• Person and family level data collected

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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

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MEPS-HC Sample Sizes

• Year Households Persons
• 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

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

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MEPS-HC Utilization Data

• Hospital stays
• Other hospital care
• Office based physician care
• Other medical providers

• Dental services
• Home health
• Prescribed medications
• Medical equipment and supplies

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MEPS- HC Periodic Supplements

• Access to care
• Satisfaction with health plans providers
• Health status
• Income

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New Supplements

• Adult SAQ
• Preventive Care
• Enhanced Access to Care Section
• Childrens Health Supplement

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Condition Supplements

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

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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

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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

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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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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.

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• Medical Expenditure Panel Survey
• DISSEMINATION OF INFORMATION AND DATA PRODUCTS

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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

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Medical Expenditure Panel Survey Methods of
Dissemination

• MEPS Website at www.meps.ahrq.gov
• MEPS e-mail address - MEPSPD_at_ahrq.gov
• AHRQ clearinghouse 800-358-9295
• for CD-ROMs and print publications

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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

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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_at_ahrq.hhs.g
  ov

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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

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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

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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

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Recent Data Releases

• 2005 First Part of Year File
• 2004 Event Files
• 1996-2004 Pooling File

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Upcoming Data Releases

• 2004 Consolidated File (Use and
  Expenditures)-November
• 2004 Condition file -November
• 2002-2004 Risk adjustment File - December

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

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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

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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

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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

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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

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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.

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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 MSAs

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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 )