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2005 National Healthcare Quality Report

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Medical Expenditure Panel Survey (MEPS)

Sponsor

U.S. Department of Health and Human Services: Agency for Healthcare Research and Quality (AHRQ); and Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

MEPS comprises three component surveys: the Household Component (HC), the Medical Provider Component (MPC) and the Insurance Component (IC). The MEPS Household Component (HC), the core survey, is an interviewer administered CAPI (computer assisted personal interview) household survey. The data for this report are primarily from the following sections of the 2001 and 2002 MEPS-HC.

  1. Self-Administered Questionnaire (SAQ)

    This self-administered paper questionnaire collects a variety of health and health care quality measures of adults. The health care quality measures in the SAQ were taken from the health plan version of CAHPS®, an AHRQ sponsored family of survey instruments designed to measure quality of care from the consumer's perspective.

  2. Diabetes Care Survey (DCS)

    This self-administered paper questionnaire, given to persons identified as ever having had diabetes, asks about their diabetes care.

  3. Child Health and Preventive Care (CHPR) section

    Starting in 2001, a Child Health and Preventive Care section was added to the MEPS-HC interviews during the second half of the year. It included: health care quality measures taken from the health plan version of CAHPS®; the Children with Special Health Care Needs Screener questions; children's general health status as measured by several questions from the General Health Subscale of the Child Health Questionnaire; Columbia Impairment Scale questions about possible child behavioral problems; and child preventive-care questions. The CAHPS® questions and the Children with Special Health Care Needs Screener questions had been in a Parent Administered paper Questionnaire (PAQ) in 2000. The PAQ estimates for 2000 may not be completely comparable to the CHPR estimates in later years due to differences in the administration of the PAQ and the CHPR section (parent self-administered paper questionnaire for the PAQ vs. interviewer-administered in-person household interview of household respondent for the CHPR).

  4. 2000 Parent Administered Questionnaire (PAQ)

    A parent self-administered questionnaire designed to collect a variety of health status and health care quality measures of children from CAHPS® and from the Children with Special Health Care Needs (CSHCN) screener. Starting in 2001, a Child Health and Preventive Care section, containing questions that had been in the 2000 PAQ, was added to the MEPS interviews.

  5. Access to Care (AC)

    The AC section of the MEPS-HC gathers information on five main topic areas: family members' origins and preferred languages; family members' usual source of health care; characteristics of usual source of health care providers; satisfaction with and access to the usual source of health care provider; and access to medical treatment, dental treatment, and prescription medicines.

  6. Preventive Care (PC)

    For each person, a series of questions was asked primarily about the receipt of preventive care or screening examinations.

Survey Sample Design

The sampling frame for the MEPS-HC is drawn from respondents to National Health Interview Survey (NHIS), conducted by the National Center for Health Statistics (NCHS). The MEPS-HC augments NHIS by selecting a sample of NHIS respondents, collecting additional data on their health care expenditures, and linking these data with additional information from the respondents' medical providers, employers, and insurance providers.

Primary Survey Content

The MEPS-HC collects detailed data on demographic characteristics, health conditions, health status, use of medical care services, charges and payments, access to care, satisfaction with care, health insurance coverage, income, and employment.

Population Targeted

Like the NHIS population from which its subpopulation is drawn, the MEPS-HC is a nationally representative survey of the U.S. civilian noninstitutionalized population.

Demographic Data

The MEPS HC collects data on demographic characteristics including: Age, gender, race, ethnicity, education, industry and occupation, employment status, household composition, and family income. Race and ethnicity variables and categories changed in 2002 to be compliant with OMB standards that required changes by 2003.

The Residence Location categories are based on 2003 urban influence codes. These codes form a 12-part county codification scheme for classifying standard Office of Management and Budget (OMB) metropolitan counties by size, and nonmetropolitan counties by size of the largest city or town as well as proximity to metropolitan and micropolitan areas. Nonmetropolitan areas are divided into micropolitan and noncore areas.

For some tables the categories Noncore-adjacent and Noncore-not adjacent were collapsed to the single category Noncore in order to generate statistically-reliable estimates.

Note that Noncore-not adjacent includes noncore counties adjacent to micropolitan areas that do not have their own town.

For more information on urban influence codes, go to: http://www.ers.usda.gov/Data/UrbanInfluenceCodes/.

Years Collected

1996 to present.

Schedule

Annual.

Geographic Estimates

National. The HC data also can be shown for the four census regions (Northeast, Midwest, South, and West), as well as Residence Location status.

Notes

AHRQ fields a new MEPS panel each year. In this design, two calendar years of information are collected from each household in a series of five rounds of data collection over a 2 and one half year period. These data are then linked with additional information collected from the respondents' medical providers, employers, and insurance providers. This series of data collection activities is repeated each year on a new sample of households, resulting in overlapping panels of survey data.

Data Suppression

Estimates in the Tables Appendix based on MEPS data are suppressed if the unweighted cell value is less than 100. Estimates are flagged if the relative standard error is greater than 30 percent.

Contact Information

Agency homepage: http://www.ahrq.gov.

Data system homepage: http://www.meps.ahrq.gov.

References

Cohen J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, MD: AHCPR, 1997.

Cohen S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, MD: AHCPR, 1997.

Cohen JW, Monheit AC, Beauregard KM, et al. The Medical Expenditure Panel Survey: A National Health Information Resource. Inquiry 33:373-389, 1996/1997. Also available as AHCPR Pub. No. 97-R043. Washington, DC: AHCPR, 1997.

Behavioral Risk Factor Surveillance System (BRFSS) Healthcare Cost and Utilization Project (HCUP)

 

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