Medical Expenditure Panel Survey

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The Medical Expenditure Panel Survey (MEPS) is a family of surveys intended to provide nationally representative estimates of health expenditure, utilization, payment sources, health status, and health insurance coverage among the noninstitutionalized, nonmilitary population of the United States. This series of government-produced data sets can be used to examine how individuals interact with the medical care system in the United States.

MEPS is administered by the Agency for Healthcare Research and Quality (AHRQ) in three components: the core Household Component, the Insurance/Employer Component, and the Medical Provider Component. Only the Household Component is available for download on the Internet. These components provide comprehensive national estimates of health care use and payment by individuals, families, and any other demographic group of interested

.[1]

History

MEPS was modeled after the National Medical Expenditure Survey (NMES) and the National Medical Care Utilization and Expenditure Survey (NMCUES), which were conducted in 1977 (NMES-1), 1980 (NMCUES), and 1987 (NMES-2). Each of these surveys was tasked with providing data on a representative sample of Americans' interaction with the medical care system. Although the NMES and NMCUES were sampled independently from the U.S. population, each new MEPS sample is drawn from the outgoing

National Health Interview Survey panel.[2][3] MEPS is generally considered the direct descendant of these surveys, and prestigious peer-reviewed journals commonly publish articles that examine trends calculated between MEPS and its predecessors.[4][5]

Research topics

The Medical Expenditure Panel Survey can be used for a wide range of topics related to the U.S. healthcare system, including Access to Care, Children's Health, Chronic Conditions,

Elderly. AHRQ continually produces chartbooks, statistical briefs, and fact sheets using MEPS data which shed light on these various facets of how the American healthcare system functions, what patients experience, how they behave, and who pays for the cost of care.[6]

Data accessibility

The MEPSnet Query Tools interactive table builder allows non-statisticians to select a data year and medical variable(s) of interest, and produce descriptive statistics and crosstabulations of Household Component and Insurance Component data from the AHRQ website.

Data available

The current[when?] publicly available Medical Expenditure Panel Survey – Household Component data set consists of six files which describe the demographics and characteristics of the survey population and eight event-level files which capture all interactions with the U.S. medical system.[7]

Household Component Full-Year Files

The six full-year files include:

Household Component Event Files

The eight event-level files generally contain one record per event, and contain various information pertaining to the specific type of event. Each record contains one or more

ICD-9
codes to describe and categorize the type of medical encounter experienced by the surveyed individual. The event-level files also contain the breakdown of spending by payor associated with the event and a date (or start and end dates) that the event took place. Each of these event files can be joined with the person-level files in a many-to-one match (on DUPERSID), where an individual with zero medical events during the calendar year would generate zero matches, but an individual with two doctor visits and a dental visit would generate three matches across all of the event files. The event-level files can also be joined with the condition files (on CONDIDX) to determine what medical expenditure can be associated with particular conditions. The eight files include:

  • The Prescribed Medicines files (released annually in October) – This file contains one household-reported prescribed medicine purchase during the calendar year. Prescription purchases are then verified by the prescribing pharmacy. In addition to the expenditure information, this file contains characteristics of the medication, such as the
    National Drug Code (NDC) identifier, the drug name, and the Multum Lexicon category. Prescribed medical events may be more difficult to analyze, since the strength of the drug and quantity purchased may vary, despite two separate prescription-events being the same chemical substance. Prescribed medical events may also be more difficult to analyze, since, unlike other recorded medical events, a pharmacy encounter does not guarantee that the medication has been administered (i.e. that the patient stuck to his or her drug regiment). This file should be thought of as containing one record per pharmacy encounter.[14]
  • The Dental Visits files (released annually in August) – The file contains one record for each dental visit during the calendar year. It includes dental-specific information such as the type of provider seen, if the visit was due to an accident, reason for the dental event, and any medication was prescribed.[15]
  • The Other Medical Expenses files (released annually in August) – This file contains one record for each medical expense that does not fit into any of the other event type categories. The events and expenditures captured in this file are overwhelmingly recorded as
    Durable Medical Equipment (such as Orthopedic items, Prostheses, Hearing Devices) also included.[16]
  • The Hospital Inpatient Stays files (released annually in October) – This file contains hospitalization-specific information including the date of and reason for the stay, the types of services received, and any procedure(s) undertaken during the hospital inpatient stay.[17]
  • The Emergency Room Visits files (released annually in September) – This file contains
    emergency room-specific information including the date of and reason for the visit, the types of services received, and any procedures(s) undertaken during the visit. Since many E.R. visits continue into Inpatient Hospital admissions, the spending incurred during any E.R. visit resulting in an Inpatient Hospital Admission gets transferred to the Hospital Inpatient Stays event file (identifiable using the ERHEVIDX variable) and the medical expenditure cannot be divided out between pre- and post-admission.[18]
  • The Outpatient Visits files (released annually in September) – This file contains information about each visit to an outpatient hospital setting, including type of test or treatment being provided, whether or not a physician was seen (and if so what specialty), and what condition or diagnosis the visit was related to.[19]
  • The Office-based Visits files (released annually in September) – This file captures each office-based encounter of all sampled individuals. This file contains all necessary descriptive information about visits to Primary Care Physicians, specialist physicians, and non-physician medical providers (such as Nurse Practitioners and Physical Therapists) that occurred outside of a hospital setting. In addition to the general event visit information, this file includes certain details about any preventive services, tests, and vaccinations received.[20]
  • The Home Health Visits files (released annually in August) – This file contains one record for each time that a certified home health medical practitioner visits a sampled individual. In addition to the standard event file variables, this file contains information about the home health medical provider's credentials and skills, the length of the visit, and the type(s) of care received. This file includes medical visits by hospice providers, which are generally paid for home-based care through the Medicare Hospice benefit.[21][22]

Publications

The Medical Expenditure Panel Survey is commonly the subject of analysis in articles on health policy and health services in research journals such as

New England Journal of Medicine.[23]

Methodology

Noninstitutionalized civilian Americans (both citizens and non-citizens) are sampled at the household, allowing for analyses of medical behavior at the family-level as well as the individual-level. Each year, households containing a total of approximately 15,000 individuals are sub-sampled from the

National Health Interview Survey's two year panel. These individuals are then followed with five in-person interviews (rounds) over the course of two years during which a complete demographic profile is collected, all medical encounters are documented, and patient-reported subjective questions regarding topics like satisfaction with care are obtained.[24]

MEPS employs a complex survey sample design in order to oversample certain population groups of interest; this survey design must be accounted for (using either the Taylor Series Linearization method or the Balanced repeated replication method) to appropriately calculate the standard errors.[25]

References

  1. ^ "Data on Health and Well-being of American Indians, Alaska Natives, and Other Native Americans | ASPE". Aspe.hhs.gov. 30 November 2006. Retrieved 2017-07-07.
  2. ^ "Summary of the Medical Expenditure Panel Survey (MEPS)". Archived from the original on 2001-11-22. Retrieved 2010-05-22.
  3. ^ "Archived copy". Archived from the original on 2016-03-03. Retrieved 2017-09-10.{{cite web}}: CS1 maint: archived copy as title (link)
  4. PMID 12519924
    .
  5. PMID 11779262
    .
  6. ^ "Medical Expenditure Panel Survey Topics". Meps.ahrq.gov. 2009-10-05. Retrieved 2017-07-07.
  7. ^ "Medical Expenditure Panel Survey Download Data Files". Meps.ahrq.gov. 2017-05-31. Retrieved 2017-07-07.
  8. ^ "Medical Expenditure Panel Survey Public Use File Details". Meps.ahrq.gov. 2006-01-08. Retrieved 2017-07-07.
  9. ^ "Medical Expenditure Panel Survey Public Use File Details". Meps.ahrq.gov. 2006-01-08. Retrieved 2017-07-07.
  10. ^ "MEPS HC-112: 2007 Medical Conditions". Meps.ahrq.gov. Retrieved 2017-07-07.
  11. ^ "HC-108: MEPS 2007 Jobs File". Meps.ahrq.gov. 2007-12-31. Retrieved 2017-07-07.
  12. ^ "MEPS HC-111: 2007 Person Round Plan Public Use File". Meps.ahrq.gov. 2007-01-01. Retrieved 2017-07-07.
  13. ^ "MEPS HC-114: MEPS Panel 11 Longitudinal Data File". Meps.ahrq.gov. 2006-01-01. Retrieved 2017-07-07.
  14. ^ "MEPS HC-110A: 2007 Prescribed Medicines". Meps.ahrq.gov. 2007-12-31. Retrieved 2017-07-07.
  15. ^ "MEPS HC-110B: 2007 Dental Visits". Meps.ahrq.gov. Retrieved 2017-07-07.
  16. ^ "Medical Expenditure Panel Survey Public Use File Details". Meps.ahrq.gov. 2006-01-08. Retrieved 2017-07-07.
  17. ^ "MEPS HC-110D: 2007 Hospital Inpatient Stays". Meps.ahrq.gov. Retrieved 2017-07-07.
  18. ^ "MEPS HC-110E: 2007 Emergency Room Visits". Meps.ahrq.gov. 2007-12-31. Retrieved 2017-07-07.
  19. ^ "MEPS HC-110F: 2007 Outpatient Department Visits". Meps.ahrq.gov. 2007-12-31. Retrieved 2017-07-07.
  20. ^ "MEPS HC-110G: 2007 Office-Based Medical Provider Visits". Meps.ahrq.gov. 2007-12-31. Retrieved 2017-07-07.
  21. ^ "MEPS HC-110H: 2007 Home Health Visits". Meps.ahrq.gov. 2007-12-31. Retrieved 2017-07-07.
  22. ^ "Archived copy" (PDF). Archived from the original (PDF) on 2010-05-27. Retrieved 2010-05-22.{{cite web}}: CS1 maint: archived copy as title (link)
  23. ^ ""Medical Expenditure Panel Survey" AND (JAMA OR "Health Affairs" OR NEJM OR "Health Services Research") – Google Scholar". scholar.google.com. Retrieved 5 July 2017.
  24. ^ "Methodology Report #1: Design and Methods of the Medical Expenditure Panel Survey Household Component". Meps.ahrq.gov. Retrieved 2017-07-07.
  25. ^ "Medical Expenditure Panel Survey Computing Standard Errors for MEPS Estimates". Archived from the original on 2009-08-13. Retrieved 2010-05-22.

External links

  • Medical Expenditure Panel Survey website
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