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
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
MEPS Survey
Components
 Household Component (HC)
– Medical Provider Component
(MPC)
– Insurance Component (IC)– Link
Sample
 Insurance Component (IC) – List
Sample
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 noninstitutionalized population of the US
 5 in-person interviews (CAPI) over 2 ½ year
period
 Person and family level data collected
Oversampling in MEPS

Every year: Blacks and Hispanics
–

1997: Selected subpopulations
–
–
–
–
–
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Carryover from NHIS
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
MEPS-HC Sample Sizes
Year
Households
1996
9,400
1997
13,500
1998-2000
10,000
2001
13,500
2002+
15,000
Persons
23,500
33,000
24,000
32,000
37,000
MEPS-HC
Core Interview Content
 Demographics
 Charges and Payments
 Health Status
 Conditions
 Utilization
 Employment
 Health Insurance
MEPS Panel Design: Data Reference Periods
2001
Q1
Q2
2002
Q3
Q4
Q1
Q2
Q3
2003
Q4
Q1
Q2
Q3
2004
Q4
Q1
Q2
Q3
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
N= 32,122
N=37,418
N is equal to the number of people with a positive person weight on the file.
N=32,681
N=32,737
Q4
MEPS Overlapping Panels
(Panels 8 and 9)
MEPS Household
Component
MEPS Panel 8 20032004
1/1/2003
NHIS
2002
Round 1
1/1/2004
Round 2
Round 3
NHIS
2003
Round 4
Round 1
Round 5
Round 2
Round 3 Round 4
MEPS Panel 9
2004-2005
Round 5
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
MEPS-HC Utilization Data
 Hospital stays
 Dental services
 Other hospital
 Home health
care
 Office based
physician care
 Other medical
providers
 Prescribed
medications
 Medical
equipment and
supplies
MEPS- HC Periodic
Supplements
 Access to care
 Satisfaction with health
plans & providers
 Health status
 Income
New Supplements
 Adult SAQ
 Preventive Care
 Enhanced Access to Care
Section
 Children’s Health
Supplement
Condition Supplements
 Priority Conditions
–
–
–
–
–
–
–

Diabetes
Asthma
Hypertension
Ischemic Heart Disease
Arthritis
Stroke
COPD
Diabetes Care SAQ (DCS)
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
Types of MEPS-HC Files
 Full-year Files - calendar year data
 Point-in-time Files - snap shot first
part of year
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
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.
Medical Expenditure Panel Survey
DISSEMINATION OF
INFORMATION AND DATA
PRODUCTS
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
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
MEPS Website
www.meps.ahrq.gov
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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
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
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
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
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
Recent Data Releases
 2005 First Part of Year File
 2004 Event Files
 1996-2004 Pooling File
Upcoming Data Releases
 2004 Consolidated File (Use and
Expenditures)-November
 2004 Condition file -November
 2002-2004 Risk adjustment File - December
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
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
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
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
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
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.
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
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 )