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National Healthcare Quality & National Healthcare Disparities Reports: Measure Specification Appendix, 2013

Access to Care: Affordability

 

Measures

People under age 65 whose family's health insurance premium and out-of-pocket medical expenditures were more than 10% of total family income
People under age 65 with private insurance whose family's health insurance premiums and out-of-pocket medical expenditures were more than 10% of total family income
People without a usual source of care who indicated a financial or insurance reason for not having a source of care
People unable to get or delayed in getting needed medical care, dental care, or prescription medicines due to financial or insurance reasons
People who were unable to get or delayed in getting needed medical care due to financial or insurance reasons in the last 12 months
People who were unable to get or delayed in getting needed dental care due to financial or insurance reasons in the last 12 months
People who were unable to get or delayed in getting needed prescription medications due to financial or insurance reasons in the last 12 months
 


 

Measure Title

People under age 65 whose family's health insurance premiums and out-of-pocket medical expenditures were more than 10% of total family income

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)

Table Description

Geographic Representation

National

Years Available

2006-2010

Population Subgroups

Activity limitation, age, education, employment status, race/ethnicity, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex

Data Sources

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)

Denominator

U.S. civilian noninstitutionalized population under age 65

Numerator

Subset of the denominator whose family's out-of-pocket medical expenditures were more than 10% of total family income

Comments

Health insurance premium is determined as the sum of insurance premiums (imputed) and Medicare Part B expenditures. Total family income is the sum of person-level pretax total income, refund income, and sale income. "Family" is defined in terms of health insurance eligibility units (HIEUs), which are composed of individuals who could be covered as a family under most private health insurance plans. For income, insurance, expenditures, and premiums, a family is defined in terms of HIEUs.

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Measure Title

People under age 65 with private insurance whose family's health insurance premiums and out-of-pocket medical expenditures were more than 10% of total family income

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)

Table Description

Geographic Representation

National

Years Available

2006-2010

Population Subgroups

Activity limitation, age, education, employment status, race/ethnicity, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex

Data Sources

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)

Denominator

U.S. civilian noninstitutionalized population under age 65 who had private insurance, including employer-sponsored and nongroup coverage

Numerator

Subset of the denominator whose family's out-of-pocket medical expenditures were more than 10% of total family income

Comments

Total family income was determined as the sum of person-level pretax total income, refund income, and sale income. "Family" is defined in terms of health insurance eligibility units (HIEUs), which are composed of individuals who could be covered as a family under most private health insurance plans. For income, insurance, expenditures, and premiums, a family is defined in terms of HIEUs. Private health insurance includes:

  • Private, employer sponsored: people who had at least 1 month of employer-sponsored insurance and zero months uninsured during the year.
  • Private, nongroup: people who had least 1 month of nongroup private insurance and zero months uninsured during the year.

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Measure Title

People without a usual source of care who indicated a financial or insurance reason for not having a source of care

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)

Table Description

Geographic Representation

National

Years Available

2002-2010

Population Subgroups

Activity limitation, age, education, employment status, race/ethnicity, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex, U.S. born

Data Sources

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)

Denominator

U.S. civilian noninstitutionalized population who reported having no usual source of care

Numerator

Subset of the denominator who indicated a financial or insurance reason for not having a usual source of care

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Measure Title

People unable to get or delayed in getting medical care, dental care, or prescription medications due to financial or insurance reasons

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)

Table Description

Geographic Representation

National

Years Available

2002-2010

Population Subgroups

Activity limitation, age, education, employment status, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex, U.S. born

Data Sources

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)

Denominator

U.S. families who reported having at least one member experience difficulties or delays in obtaining health care

Numerator

Subset of the denominator who indicated difficulties or delays in obtaining health care related to: (1) affordability, (2) lack of approval or change by insurance company, (3) inability to get a referral, or (4) expense associated with the site of care.

Comments

Race, ethnicity, family income, and education characteristics are those of the family reference person and are used to characterize the entire family unit.

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Measure Title

People who were unable to get or delayed in getting needed medical care due to financial or insurance reasons in the last 12 months

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)

Table Description

Geographic Representation

National

Years Available

2002-2010

Population Subgroups

Activity limitation, age, education, employment status, race/ethnicity, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex, U.S. born

Data Sources

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)

Denominator

U.S. families reporting that at least one family member experienced difficulty in obtaining health care, including those with members who attempted but did not receive care or delayed the needed care

Numerator

Subset of the denominator reporting each of three reasons causing difficulty in obtaining health care: (1) cost (could not afford), (2) insurance-related reasons, and (3) other reasons in the last 12 months.

Comments

This measure is referred to as measure AHS-6.1 in Healthy People 2020 documentation.

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Measure Title

People who were unable to get or delayed in getting needed dental care due to financial or insurance reasons in the last 12 months

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)

Table Description

Geographic Representation

National

Years Available

2002-2010

Population Subgroups

Activity limitation, age, education, employment status, race/ethnicity, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex, U.S. born

Data Sources

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)

Denominator

U.S. families reporting that at least one family member experienced difficulty in obtaining health care, including those with members who attempted but did not receive care or delayed the needed care

Numerator

Subset of the denominator reporting each of three reasons causing difficulty in obtaining health care: (1) cost (could not afford), (2) insurance-related reasons, and (3) other reasons in the last 12 months.

Comments

This measure is referred to as measure AHS-6.1 in Healthy People 2020 documentation.

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Measure Title

People who were unable to get or delayed in getting needed prescription medications due to financial or insurance reasons in the last 12 months

Measure Source

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)

Table Description

Geographic Representation

National

Years Available

2002-2010

Population Subgroups

Activity limitation, age, education, employment status, race/ethnicity, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex, U.S. born

Data Sources

Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)

Denominator

U.S. families reporting that at least one family member experienced difficulty in obtaining health care, including those with members who attempted but did not receive care or delayed the needed care

Numerator

Subset of the denominator reporting each of three reasons causing difficulty in obtaining health care: (1) cost (could not afford), (2) insurance-related reasons, and (3) other reasons in the last 12 months.

Comments

This measure is referred to as measure AHS-6.1 in Healthy People 2020 documentation.

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Page last reviewed July 2014
Page originally created July 2014
Internet Citation: National Healthcare Quality & National Healthcare Disparities Reports: Measure Specification Appendix, 2013. Content last reviewed July 2014. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/research/findings/nhqrdr/nhqrdr13/measurespec/access-affordability.html

 

The information on this page is archived and provided for reference purposes only.

 

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