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Monitoring the Health Care Safety Net
Slide Presentation by Lynn A. Blewett, Ph.D.
On September 24, 2003, Lynn A. Blewett, Ph.D., made a presentation in the Web-Assisted Audioconference entitled Safety Net Data Collection Strategies.
This is the text version of Dr. Blewett's slide presentation. Select to access the PowerPoint® slides (151 KB).
Safety Net Data Collection Strategies
Lynn A. Blewett, Ph.D.
State Health Access Data Assistance Center
School of Public Health, University of Minnesota
Supported by a grant from The Robert Wood Johnson Foundation
Estimating the Number of Uninsured
- Estimates of demand based on state and local estimates of the number of uninsured.
- Most estimates come from household surveys that ask about health insurance coverage.
- Also used in combination with employer surveys that ask about health insurance coverage.
Estimating the Size of the Uninsured Populations at the Local Level
- Do your own survey
- To directly measure health insurance coverage and rates of uninsurance
- Use existing available data to:
- Develop proxy measures of uninsurance
- Develop statistical model-based estimates
Direct Measures: National Data
- Three surveys provide state-level estimates of health insurance coverage.
- Current Population Survey (CPS): Census
- Medical Expenditure Panel (Employer) Survey - Insurance Component (MEPS-IC):
Agency for Healthcare Research and Quality
- State and Local Area Integrated Telephone Survey (SLAITS):
National Center for Health Statistics
Direct Measures: State Data
- 37 States have developed and fielded their own state household survey to estimate levels of health insurance coverage
- Many funded by the federal Health Resources Services and Administration State Planning
- Typically have larger sample size and some regional/county estimates of coverage
Other National Surveys of Note
- National Survey of America's Families (NSAF): Urban Institute
- Uninsurance estimates available for 13 states
- Public use files available to states for analysis
- Community Tracking Study: Center for Health System Change
- Uninsurance estimates can be made for the 12 communities in the CTS sample
- Use an available measure to serve as a proxy for health insurance coverage
- Example: self-pay variable from hospital administrative records to estimate local
levels of uninsurance
- Predicts health insurance coverage using one or more variables correlated with health
- Example: correlation between state unemployment and uninsurance and applying this at local level
National Model-Based Estimates
- Small-Area Estimation
- Census and AHRQ are both working on sophisticated models to provide state and local area estimates
- CPS: Uninsurance
- MEPS-IC: Employment offer and take up rates
This slide contains a table showing an Overview of Approaches for Estimating Number of Uninsured At the Local Level. The principal strength of the Direct Estimation-New Survey approach is precision; the principal weakness of this approach is cost. The principal strength of the proxy measure approach is cost; the principal weakness of this approach is bias. The principal strength of the model-based approach is predictive accuracy; the principal weakness is complexity.
- Be knowledgeable and aware of different data sources available for your community
- Use existing resources and data and build on existing state and local survey activities
- Use multiple approaches to maximize information
- Be flexible as new data become available
2221 University Avenue, Suite 345
Minneapolis Minnesota 55414
Principal Investigator: Lynn Blewett, Ph.D. firstname.lastname@example.org
Co-Principal Investigator: Kathleen Call, Ph.D. email@example.com
Center Director: Kelli Johnson, M.B.A. firstname.lastname@example.org
Senior Research Associate: Timothy Beebe, Ph.D. email@example.com
Research Associate: Michael Davern, Ph.D. firstname.lastname@example.org
Current as of February 2004
Safety Net Data Collection Strategies. Text Version of a Slide Presentation at a Web-assisted Audioconference. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/safetynetaud/sess2/blewetttxt.htm
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