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National Healthcare Disparities Report, 2004

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3. Other (Row) Variables

Age

Three age categories were developed for the NHDR tables on elderly community residents: 65 to 74, 75 to 84, and 85 and older. Each sample person was assigned to a category based on his or her age as of July 1 of the data year.

Gender

Gender is recorded as reported on the Medicare/Social Security administrative record for the sample person.

Insurance Coverage

Insurance coverage in the MCBS is based on a combination of Medicare and Medicaid administrative data and survey-reported information on public and private insurance. The information is used to construct month-by-month timelines of coverage by type of insurance for each sample person in a Cost and Use file. In addition, summary health insurance variables are created by using the month-by-month variables to identify persons who had a particular type of insurance at any time in the year.

The types of insurance identified in the MCBS include Medicare fee-for-service, Medicare managed care, Medicaid, private employer-sponsored, private individually purchased (Medigap), private health maintenance organization, and other insurance. Summary versions of these variables were used to create four mutually exclusive groups of Medicare beneficiaries by prioritizing insurance coverage as follows:

  • Group 1 contains everyone who had Medicaid regardless of other coverage.
  • Group 2 contains persons in Medicare managed care plans regardless of other coverage.
  • Group 3 contains persons with private insurance (Medigap, employer-sponsored or HMO).
  • Group 4 contains all remaining beneficiaries, i.e., Medicare fee-for-service beneficiaries who did not have Medicaid or private insurance.

Urban/rural

Sample persons are classified as living in a metropolitan or non-metropolitan area based on their addresses in the Medicare administrative files.

Perceived Health Status

Each sample person in the MCBS is asked to compare his or her general health to other persons of the same age. Persons receiving a community interview answer the question themselves. If a sample person is not able to do so, the proxy for that person answers the question. The possible responses to the question include excellent, very good, good, fair, and poor. Persons reporting fair or poor health are shown in the NHDR tables.

Functional Limitations

Sample persons are identified as having functional limitations through their responses to six sets of questions about activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Sample persons are asked whether they have a health or physical problem that makes it difficult to perform any of the specified activities. If the response is yes, they are recorded as having a limitation in that particular activity. If the response is "doesn't do," they are asked whether it is because of a health or physical problem. Then, if the response to the follow-up question is "yes," they are recorded as having a limitation in that particular activity.

The ADLs are activities related to personal care; and, they include bathing or showering, dressing, eating, getting in or out of bed or a chair, walking, and toileting. The IADLs are activities related to independent living; and, they include using the telephone, doing light housework, doing heavy housework, preparing meals, shopping for personal items, and managing money. Any limitation reported by a sample person may have been temporary or chronic at the time of the interview.

 

 

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