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New MEPS reports are now available

Several new reports are now available that present findings from the Medical Expenditure Panel Survey (MEPS). MEPS is the third in a series of nationally representative surveys of medical care use and expenditures sponsored by the Agency for Health Care Policy and Research. MEPS is cosponsored by the National Center for Health Statistics (NCHS). The first of these surveys, the National Medical Care Expenditure Survey (NMCES), was conducted in 1977, and the second, the National Medical Expenditure Survey (NMES), was carried out in 1987.

MEPS collects detailed information on health care use and expenses, sources of payment, and insurance coverage of individuals and families in the United States. The reports summarized here are available from the AHCPR Clearinghouse.

In addition, the MEPS 1996 Medical Conditions (HC-006) public use data file is now available on the MEPS Web site. This file is the first medical conditions public use data file to be released from the 1996 Medical Expenditure Panel Survey Household Component (MEPS HC). It consists of 1996 data obtained in Panel 1, Rounds 1, 2, and 3 of the survey and contains variables pertaining to household-reported medical conditions including accidents and injuries, ICD-9-CM diagnosis and procedure codes, and alternative care.

Health Care Use in America, 1996. MEPS Highlights No. 9 (AHCPR Publication No. 99-0029). Available through the AHCPR Clearinghouse.

This report examines variations in the use of health care services among selected subgroups of the U.S. civilian noninstitutionalized population in 1996. It is based on the more detailed publication, Use of Health Care Services, 1996 (AHCPR Publication No. 99-0018), and is available from the AHCPR Clearinghouse. Major highlights include the following: About 75 percent of Americans had at least one ambulatory care visit with either a physician or nonphysician provider during 1996; use of ambulatory care and dental care was lower among blacks and Hispanics than among whites and others combined; over 60 percent of the civilian noninstitutionalized population who died during 1996 (compared with only 7 percent of the rest of the population) had a hospitalization during the year; among people under age 65, the uninsured were the least likely to have had any outpatient care or to have had a prescription medicine; and, elderly people (over age 65) were the age group most likely to have had at least one prescription medicine.

Nursing Home Trends, 1987 and 1996. MEPS Chartbook No. 3 (AHCPR Publication No. 99-0032). Available through the AHCPR Clearinghouse.

This chartbook presents estimates on the nursing home market and characteristics of the nursing home population. Nursing home facilities and residents in 1987 and 1996 are compared. Information on special care units is given for 1996 only. The number of nursing homes and the number of nursing home beds both increased almost 20 percent from 1987 to 1996; 73 percent of nursing homes were certified by both Medicare and Medicaid in 1996, up from 28 percent in 1987. Passage of the Omnibus Budget Reconciliation Act of 1987 reduced the incentive to remain certified by Medicaid only. Growth in the elderly population outpaced growth in the supply of nursing home beds. Nursing homes were caring for an older population in 1996 than in 1987. Moreover, functional disability among nursing home residents increased: 83 percent of residents in 1996 needed help with three or more activities of daily living, compared with 72 percent in 1987. As for special care units, a relatively new phenomenon, the most common type in 1996 was for patients with Alzheimer's and related dementias.

Health Insurance Status of the Civilian Noninstitutionalized Population, 1997. MEPS Research Findings No. 8 (AHCPR Publication No. 99-0030). Available through the AHCPR Clearinghouse.

This report provides preliminary estimates of the health insurance status of the civilian noninstitutionalized U.S. population during the first half of 1997, including the size and characteristics of the population with private health insurance, with public insurance, and without any health care coverage. During this period, 83.2 percent of all Americans were covered by private or public health insurance, leaving 16.8 percent of the population, some 44.6 million people, uninsured. Among the non-elderly population, 81.1 percent of Americans had either private or public coverage, and 18.9 percent of the population (44.2 million people) were without health care coverage. The probability that an individual would be uninsured during this period was especially high for young adults aged 19 to 24 and members of racial and ethnic minorities (especially Hispanic males). Public health insurance continues to play an important role in ensuring that children, black Americans, and Hispanic Americans obtain health care coverage.

Changes in the Medicaid Community Population, 1987-1996. MEPS Research Findings No. 9 AHCPR Publication No. 99-0042. Available from the AHCPR Clearinghouse.

This report uses MEPS data and NMES data to compare the composition of the noninstitutionalized Medicaid population in 1996 and 1987. The Medicaid community population grew significantly over this time period, at the same time as a number of expansions in eligibility rules extended Medicaid coverage to people not receiving cash assistance. In both years, children, the elderly, minorities, and the nonworking population were more likely than others to be enrolled in Medicaid, as were the sick and disabled. Children made up nearly half of the Medicaid community population in both years. The composition of the Medicaid community population shifted slightly but significantly over the decade. There were relatively higher proportions of whites and men and relatively lower proportions of women and blacks enrolled in Medicaid in 1996 than in 1987. The proportion of the total Medicaid community population made up of non-elderly adults fell during this time period, but a much greater proportion of these non-elderly Medicaid adults were employed in 1996 than in 1987. Also, in 1996 many more of the parents of Medicaid-enrolled children worked. These shifts have significant implications for the administration of Medicaid.

Estimation Procedures in the 1996 Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 5 (AHCPR Publication No. 99-0027). Available from the AHCPR Clearinghouse.

The Household Component (HC) of MEPS produces national and regional estimates of the health care use, expenditures, sources of payment, and insurance coverage of the U.S. civilian noninstitutionalized population. The HC sample design is a stratified multistage area probability design with disproportionate sampling to facilitate the selection of an oversample of minorities. This report provides an overall summary of HC sample yields across the three rounds of data collection that cover calendar year 1996. It also provides an overview of the weighting strategies used to obtain national estimates of health care parameters for the population. Survey design complexities that require special consideration for variance estimation and analysis are discussed.

List Sample Design of the 1996 Medical Expenditure Panel Survey Insurance Component. MEPS Methodology Report No. 6 (AHCPR Publication No. 99-0037). Available from the AHCPR Clearinghouse.

The Insurance Component (IC) of MEPS collects employment-related health insurance information, such as premiums and types of plans offered. Respondent characteristics—such as size of business, employee characteristics, and type of industry—also are collected. This report outlines the process used to allocate and select the MEPS IC list sample, including goals, development of allocation schemes, and selection methods. The list sample is collected from samples developed from three lists that together cover almost 100 percent of the employers in the United States.

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