MEPS Overview - CISER Home Page
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Transcript MEPS Overview - CISER Home Page
Using AHRQ Data at Census RDC’s
Health Data Workshop
May 6, 2009
Doris Lefkowitz
Outline
Discuss Key Features of the Medical
Expenditure Panel Survey
Discuss how to apply to use MEPS data
at an RDC
Discuss How to get additional
information on MEPS
MEPS
Medical Expenditure Panel Survey
Relatively large, longitudinal study of the US
civilian, non-institutionalized population
Collects information for all members of the
household
Conducted in 1977, 1987 and annually since
1996
MEPS Survey
Components
MEPS-HC -- Household Component
MEPS-MPC -- Medical Provider Component
MEPS-IC -- Insurance Component
Key Features of MEPS-HC
Survey of U.S. civilian noninstitutionalized population
Sub-sample of respondents to the National Health
Interview Survey (NHIS)
Oversample of policy relevant target groups
Panel Survey – new panel introduced each year
– Continuous data collection over 2 ½ year period
– 5 in-person interviews (CAPI)
Sample size: about 12K families and 32K persons
since 2001
Household Participation
Verbal consent obtained from household respondent.
Each household member is asked to give written
consent to allow us to contact their medical providers
Informed consent procedure includes a video and
written materials mailed to the household
Each household is interviewed 5 times over 2 ½ years
Interviews typically last 1.5 -2 hours and are
conducted in the home on a laptop computer by a
trained interviewer
A single respondent provides most of the information
for the household
MEPS Panel Design: Data Reference Periods
2005
Q1
Q2
2006
Q3
Q4
Q1
Q2
Q3
2007
Q4
Q1
Q2
Q3
Panel 9
Round 3
Round 4
Round 5
Panel 10
Round 1
Round 2
Round 3
Round 4
Round 5
Panel 11
Round 1
Round 2
Round 3
Round 4
Round 5
Panel 12
Round 1
Round 2
Round 3
Sample Size
N = 32,320
N is equal to the number of people with a positive person weight on the file.
N = 32,577
N = 29,370
Q4
MEPS-HC
Core Interview Content
Demographics
Charges and Payments
Health Status
Conditions
Utilization
Employment
Health Insurance
Healthcare Use
Hospitalizations
Outpatient and emergency department visits
Visits to physicians and other health care providers
(nurses, PA, OT/PT, therapists, mental health
professionals)
Prescribed medications
Home health care
Durable medical equipment and supplies
Dental care
Detail for each event
Date
Provider name and type
Condition associated with the event
Some details about the event (tests performed,
medications prescribed)
Charges, payments
MEPS- HC Supplemental CAPI
Sections
Sections asked in rounds 2 and 4:
Access to care
Child preventive health
Satisfaction with health plans &
providers
Sections asked in rounds 3 and 5:
Assets (round 5 only)
Income
Preventive Care
MEPS-HC Supplemental Paper
Questionnaires
Diabetes Care SAQ
Adult SAQ
Types of MEPS-HC Files
Full-year Files - calendar year data
Point-in-time Files - snap shot first
part of year
Levels of MEPS-HC Public
Use Files
Person Level - detailed person
information
Event Level - detailed event level
information
Condition Level - detailed condition
information
Job Level - detailed job information
MEPS Medical Provider
Component (MPC) Sample
All hospitals (and associated doctors),
emergency rooms, and out-patient
departments used by respondents
All home health agencies
All pharmacies
A sample of office-based physicians
MEPS Medical Provider
Component (MPC) - Purpose
Compensate for household item
non-response
Accuracy and detail
Imputation source
Methodological studies
MEPS: Pharmacy Component
8000 pharmacies sampled
– data on prescribed medicines purchased
by households
Data obtained:
– Medication Name
– National Drug Code (NDC)
– Quantity Dispensed
– Strength and Form
– Sources of Payment
– Amount Paid by Each Source
MEPS Insurance Component (IC)
An independent survey of employers and unions
not linked to the household survey
The sample contains information from about
45,000 establishments drawn from a Census
Bureau frame and supports national and statelevel estimates for all 50 states.
Data released in tabular form on the MEPS web
site
MEPS-IC Purpose
Employer-sponsored Health Insurance
– Availability
– Enrollment
– Benefit and payment provisions
– Cost
Data Use Restrictions - MEPS
AHRQ makes specific promises to people
and establishments who participate in the
MEPS
– Data will only be used for research and
statistical purposes
– Data that COULD be used to identify them will
not be released beyond AHRQ and its
contractors
– Information about them will only be reported in
a summary fashion
Data Use Restrictions – IRB
Our IRB reviews our data collection and
release procedures
– Affirms the ideas of our authorizing legislation
– Requires review by a nosologist and
pharmacist for rare conditions and
medications to reduce inferential identification
– Requires judgments to be made on releases of
certain variables
AHRQ Data Center History
AHRQ has operated a data center at its
Rockville headquarters since 2000
Provides researchers access to non-public
use MEPS data;
Partnership with Census RDC’s is an
extension of our commitment to have
MEPS data used to the fullest extent
possible
AHRQ Data Center (ADC)
Mode of data access
– on secure LAN at AHRQ -
Rockville, Maryland
– task order agreement with data
contractor
– combinations of both
AHRQ Data Center
Researcher may bring data in, but not out
Researcher has access only to data
needed for approved project
All tabular data will be reviewed for
confidentiality before release from Center
Only approved tables can leave the
Center
Center will store data files, foreign merge
files, and all outputs needed for
replication
AHRQ Facilities
Secure room
Terminal connected to secure LAN
SAS, STATA, GAUSS, Stat Transfer,
SUDAAN, Limdep, EQS software
available, and others upon request
Limited staff support by people who
know:
– the data
– the confidentiality issues
– the software
AHRQ Application
Process
Application procedures are on the
MEPS web site
Submit proposal to data center
coordinator
Review within 1 week for feasibility,
and data availability
Institutional Review Board (IRB)
review required
AHRQ Fees
User fee of $150.00 for approved projects to
cover technical assistance, simple file
construction, and/or up 2 hours of
programming support from data contractor
Additional programming support available
from an AHRQ contractor at a cost of
$80.00/hr
User fee waived for full-time students
User fee waived for those intending to move
to a Census RDC
AHRQ Remote Access
Once the researcher has an
established data center project, and
has worked on site to develop and
debug programs, jobs may be
submitted to our Data Center
Supervisor to run.
Out-put will be reviewed for
confidentiality and mailed to the user
Confidential Data Available
for ADC Projects
Geographic data and links based on
geographic data
State Identifiers
HC-IC linked files for 1996-99
MEPS NHC for 1996
Selected Medical Provider Component
Data
Confidential Data Available
for ADC Projects
Fully specified ICD-9 codes
Continuous measure of poverty status
Fully specified Industry and Occupation
codes
Asset data
Imputed NDC codes for prescription drugs
Federal and state marginal tax rates
Other variables developed by AHQR
researchers
Partnership with Census
Applicants can begin contact with
either AHRQ or their local Census
RDC
AHRQ will request the applicant fill
out the AHRQ data center application
Partnership with Census
AHRQ reviews the application
– Does the project conform with AHRQ’s
authorizing legislation
– Does the data available support the
analysis
AHRQ sign off is quick, usually
completed in less that 2 weeks
Partnership with Census
While AHRQ requests an AHRQ data
center application for persons
wishing to use the Census RDC, the
application fee is waived
These procedures apply to MEPS
household data only. MEPS
Insurance Component data follows
the customary Census procedures for
Title 13 data
Partnership with Census
Application process moves to
Census for approval
AHRQ will begin preparing the
analytic file for the project
During the Census review and
security process, applicant could
chose to use the AHRQ data center
Partnership with Census
AHRQ staff historically provide
extensive support for all data users
We have an active list serve and
routinely answer hundreds of user
questions each year
Customers using Census RDCs
should not hesitate to continue to
interact with AHRQ
Other Resources
Information found on the MEPS Web
site: www.meps.ahrq.gov
Overview of MEPS, Fact Sheets, and FAQs
Survey instruments
Findings/Statistical Briefs/Chart books
Methods reports
Data files
Bibliography
MEPS data workshop information and schedule
Mailing list/List server
Data Center Information