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 – – – – – 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 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 )