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self index.cfm
site_filepath /www/sites/mfapp/templates/main/
 
Alan Trachtenberg, Md  
     
     
AHRQ's MEPS(Medical Expenditure)
"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">









Medical Expenditure Panel Survey (MEPS)


Overview of the MEPS Web Site




The Medical Expenditure Panel Survey (MEPS) is a vital resource designed to continually provide policymakers, health care administrators, businesses, and others with timely, comprehensive information about health care use and costs in the United States, and to improve the accuracy of their economic projections.


MEPS collects data on the specific health services that Americans use, how frequently they use them, the cost of these services, and how they are paid for, as well as data on the cost, scope, and breadth of private health insurance held by and available to the U.S. population.


MEPS is supported by the Agency for Healthcare Research and Quality (AHRQ).




Contents



What is MEPS?

Background

MEPS Fact Sheets

MEPS Conducts Three Surveys

arrow Household Component

arrow Medical Provider Component

arrow Insurance Component

Other Surveys in MEPS

arrow 1996 Nursing Home Component Survey

arrow Pharmacy Component

Frequently Asked Questions

Data & Publications

Public Use Data

arrow Database of Household Component Files

   arrow Types of Files from the Household Survey

   arrow Household Survey Variable Locators

arrow Database of the 1996 Nursing Home Component Files

   arrow Nursing Home Component Facility Level Files

   arrow Nursing Home Component Person Characteristic Files

Tabulated Data

arrow Tables from the Household Survey (Tables Compendia)

arrow Tables from the Establishment Survey on Employer-based Health Insurance

   (Insurance Component Tables)

MEPSnet

arrow MEPSnet/IC

arrow MEPSnet/HC

MEPS Publications

arrow MEPS Methodology Reports

arrow MEPS Research Findings

arrow MEPS Highlights

arrow MEPS Chartbooks

arrow MEPS Journal Articles

arrow MEPS Statistical Briefs

arrow MEPS Publications Database

Data Workshop

Data Center

What's New

Survey Instruments

MEPS Household Component Survey Instrument

MEPS Household Component Interview Showcards

MEPS Household Component Paper Instruments

Data Collection Schedule for MEPS HC Supplements

MEPS 1996 Nursing Home Component Survey Instrument

MEPS Insurance Component Survey Instrument

MEPS Medical Provider Component Survey Instrument

Mailing List/List Server

Participant's Corner

More Information





What is MEPS?


MEPS (the Medical Expenditure Panel Survey) is a survey of the civilian population living in U.S. communities. MEPS produces nationally representative statistics on health care expenses, including the type of medical services used, how frequently they are used, the cost of services, and how they are paid for, as well as health conditions and health insurance availability and coverage. MEPS also collects extensive information on employer-based health insurance plans. MEPS is cosponsored by the Agency for Healthcare Research and Quality (AHRQ) and the National Center for Health Statistics (NCHS).


For more introductory information about MEPS and its
design, go to: http://www.meps.ahrq.gov/WhatIsMEPS/Overview.HTM.


Return to Contents


Background


MEPS is the third in a series of national probability surveys conducted by AHRQ on the financing and use of medical care in the United States. The National Medical Care Expenditure Survey (NMCES) was conducted in 1997; the National Medical Expenditure Survey (NMES), in 1987. Beginning in 1996, MEPS continues this series with design enhancements and efficiencies that provide a more current data resource to capture the changing dynamics of the health care delivery and insurance system. The design efficiencies incorporated into MEPS are in accordance with the Department of Health and Human Services (HHS) Survey Integration Plan of June 1995, which focused on consolidating HHS surveys, achieving cost efficiencies, reducing respondent burden, and enhancing analytical capacities. To accommodate these goals, new MEPS design features include linkage with the National Health Interview Survey (NHIS), from which the sample for the MEPS Household Component (HC) is drawn, and enhanced longitudinal data collection for core survey components. 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 collected from the respondents' medical providers, employers, and insurance providers.


Return to Contents


MEPS Fact Sheets


MEPS provides policymakers, health care administrators, businesses, and others with timely information to use in policy-related and behavioral research on the determinants of health care use, spending, and insurance coverage and to improve the accuracy of economic projections. In fact, the Institute of Medicine has determined that MEPS produces the most comprehensive data on America's use of health services and how health care is paid.


To learn more about the benefits and advantages of MEPS data, see the MEPS Fact Sheets:




Return to Contents


MEPS Conducts Three Surveys


MEPS conducts three separate but related surveys:



Household Component Survey (HC)


The MEPS Household Component Survey (HC), a nationally representative survey of the U.S. civilian noninstitutionalized population, collects medical expenditure data at both the person and household levels. The 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.


The HC uses an overlapping panel design in which data are collected through a preliminary contact followed by a series of five rounds of interviews over a 2 1/2-year period. Using computer-assisted personal interviewing (CAPI) technology, data on medical expenditures and use for two calendar years are collected from each household. This series of data collection rounds is launched each subsequent year on a new sample of households to provide overlapping panels of survey data and, when combined with other ongoing panels, provides continuous and current estimates of health care expenditures.


The sampling frame for the MEPS HC is drawn from respondents to NHIS, conducted by NCHS. NHIS provides a nationally representative sample of the U.S. civilian noninstitutionalized population, with an oversampling of Hispanics and blacks.


Medical Provider Component Survey (MPC)


The Medical Provider Component Survey (MPC) supplements and validates information on medical care events reported in the MEPS HC by contacting medical providers and pharmacies identified by household respondents. The MPC sample includes all hospitals, hospital physicians, home health agencies, and pharmacies reported in the HC. Also included in the MPC are all office-based physicians:



  • Providing care for HC respondents receiving Medicaid.
  • Associated with a 75 percent sample of households receiving care through an HMO (health maintenance organization) or managed care plan.
  • Associated with a 25 percent sample of the remaining households.


Data are collected on medical and financial characteristics of medical and pharmacy events reported by HC respondents, including:


  • Diagnoses coded according to ICD-9 (Ninth Revision, International Classification of Diseases) and DSMIV (Fourth Edition, Diagnostic and Statistical Manual of Mental Disorders).
  • Physician procedure codes classified by CPT-4 (Current Procedural Terminology, Version 4).
  • Inpatient stay codes classified by DRG (diagnosis-related group).
  • Prescriptions coded by national drug code (NDC), medication names, strength, and quantity dispensed.
  • Charges, payments, and the reasons for any difference between charges and payments.


The MPC is conducted through telephone interviews and mailed survey materials. Its data are available on HC public use data files.


Insurance Component Survey (IC)


The Insurance Component Survey (IC) collects data on health insurance plans obtained through private and public-sector employers. Data obtained in the IC include the number and types of private insurance plans offered, benefits associated with these plans, premiums, contributions by employers and employees, and employer characteristics. Establishments participating in the MEPS IC are selected through three sampling frames:



  • A list of employers or other insurance providers identified by MEPS HC respondents who report having private health insurance at the Round 1 interview.
  • A Bureau of the Census list frame of private-sector business establishments.
  • The Census of Governments from the Bureau of the Census.

To provide an integrated picture of health insurance, data collected from the first sampling frame (employers and other insurance providers) are linked back to data provided by the MEPS HC respondents. Data from the other sampling frames are collected to provide annual national and State estimates of the supply of private health insurance available to American workers and to evaluate policy issues pertaining to health insurance. Beginning in 2000, national estimates of employer contributions to group health insurance from the MEPS IC are being used in the computation of Gross Domestic Product (GDP) by the Bureau of Economic Analysis.


The MEPS IC is an annual panel survey. Data are collected from the selected organizations through a prescreening telephone interview, a mailed questionnaire, and a telephone followup for nonrespondents.


The MEPS IC Survey is also known as the Health Insurance Cost Study.


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Other Surveys in MEPS


1996 Nursing Home Component Survey (NHC)


The 1996 NHC was a survey of a sample of nursing home and persons residing in or admitted to nursing homes nationwide at any time during the calendar year 1996. The NHC gathered information on the demographic characteristics, residence history, health and functional status, use of services, use of prescription medications, and health care expenditures of nursing home residents. Nursing home administrators and designated staff also provided information on facility size, ownership, certification status, services provided, revenues and expenses, and facility characteristics. Data on the income assets, family relationships, and caregiving services for sampled nursing home residents were obtained form next-of-kin or other knowledgeable persons in the community.


The 1996 MEPS NHC sample was selected using a two-stage stratified probability design. In the first stage, facilities were selected; in the second stage, facility residents were sampled, selecting both persons in residence on January 1, 1996, and those admitted during the period January 1 through December 31. The sampling frame for facilities was derived from the National Health Provider Inventory, which is updated periodically by NCHS. The MEPS NHC data were collected in person in three rounds of data collection over a 1 1/2-year period using the CAPI system. Community data were collected by telephone using computer-assisted telephone interviewing (CATI) technology. At the end of three rounds of data collection, the sample consisted of 815 responding facilities, 3,209 residents in the facility on January 1, and 2,690 eligible residents admitted during 1996.


Pharmacy Component (PC)


The PC is a mail survey of the pharmacy providers identified by household respondents during the series of MEPS interviews. During the last of these interviews, the household respondents were asked to sign permission forms authorizing the MEPS project to contact their pharmacies and authorizing the pharmacies to release a respondent's pharmacy records. Only those pharmacies for which a household respondent signed this permission form were included in the linked follow-back survey.


The pharmacies were asked to provide information about each prescription filled or refilled for the named patients. For each medication, they were asked to provide such information as:



  • The date the prescription was filled or refilled.
  • The medication name (generic or brand).
  • The strength of the medicine.
  • The quantity dispensed.
  • The total charge.
  • The sources of payment.

The initial mailings were directed to the individual retail pharmacies or other specific locations identified by the household respondents as the places from which household members had obtained their prescriptions. Although it was expected that some pharmacy chains might require corporate permission before allowing their individual locations to participate and that some would prefer to provide information from regional or corporate resources, the plan was to make the first contacts at the individual locations, working up the corporate ladder only after being referred there by the local pharmacies. "Chain" codes were assigned to the individual pharmacies, creating a mechanism for associating local establishments with a shared corporate parent.


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Frequently Asked Questions


For more information on specific surveys of MEPS, go to: http://www.meps.ahrq.gov/FAQs/FAQ_TOC.HTM, which groups questions and answers by components.


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Data & Publications



MEPS disseminates its health care data and publications in a variety of formats. Users may download public use files directly from the MEPS Web site or order them as diskettes (floppy disks) or CD-ROMs from AHRQ. Users may also review MEPS data already tabulated, and, in some instances, customize those tables to fit their needs. For those users who would like to interact with MEPS data but have limited programming resources, an online analytical tool called MEPSnet is available. And finally, users can browse MEPS research done by AHRQ and outside researchers.


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Public Use Data


Database of Household Component (HC) Files


Files from the Household survey are housed in the on-line PUF (public use file) database. The database has a number of search features to help the user locate MEPS HC public use data, such as searching by data file type, data year, PUF number, or keywords. The HC data files that are available for downloading are provided in both ASCII and SAS formats. Documentation, codebooks and other supplemental information for these files can be accessed as PDF or HTML files.


Types of Files from the Household Survey


Household Component Full-Year Files: A series of calendar specific MEPS public use data files (PUFs) are produced annually. Each of these files includes full-year information from several rounds of data collection which together comprise a complete calendar year's worth of information for a person.


Full-year data files vary in structure depending on the nature of file content and include data at four different levels of analysis:


  • Person-level files: Each record on the file represents the person. A person-level file record includes characteristics such as age, race, or sex associated with each person.
  • Condition-level files: Each record represents a household-reported health condition reported by a particular person.
  • Job-level files: Each record represents a job and includes characteristics, such as wages, benefits, and industry, of the job.
  • Event-level files: These are data files in which each record represents a unique household-reported medical event. They include characteristics associated with that event. MEPS releases eight event files:

    • Dental.
    • Emergency room.
    • Home health.
    • Hospital stays.
    • Medical visits.
    • Outpatient stays.
    • Other medical.
    • Prescribed medicines.

Household Component Point-in-Time Files: These files produce a snapshot of what is going on at a fixed point in time. For MEPS files, the point in time is the first part of the calendar year. These files contain minimum data elements at the person level and are intended to give analysts an early glimpse of what the full year estimates will likely be.


MEPS Pooled Estimation Linkage File: More than 1 year of MEPS survey data may be pooled to do research over more than 1 year of time. For instance, one might wish to do longitudinal research for a panel of persons who are in the sample for more than one year. Because the survey sample over the years was selected so that both persons and localities may repeat, plus the original selection used a complex survey design, estimates of errors must consider this unified design. This file is provided for use with pooled data from the MEPS full year files. Its unified design structure should be used with specialized software, such as SUDAAN, STATA, or WESVAR to calculate estimates of sampling errors.


Household Component-NHIS Link File: Each year the sample for the MEPS Household Survey is derived from the previous year's National Health Interview Survey (NHIS). The NHIS/MEPS linkage file allows users to link persons in the MEPS public use file to the records of the same person in the NHIS data file. This link files is available only by request.


Household Component-Insurance Component Linked Data with Premium Information File: This file collects information on health insurance premiums and employee contributions to premiums for all those offered health insurance through their employer. The employers of jobholders who are identified in the MEPS Household Component are surveyed as part of the MEPS Insurance Component, and the information is linked back to individual jobholders. Employers (and unions) are asked about health insurance offerings, premiums, and employee contributions to premiums. A confidential data file containing the linked premium for all jobholders is available for research purposes through the CCFS Data Center.


Projected MEPS Data: These files provide MEPS health expenditure data that have been projected from the 1996 Medical Expenditure Panel Survey by re-weighting the population using Vital Statistics data on demographic, mortality, and fertility changes in the U.S. Population and Census predictions for changes in the future.


Household Survey Variable Locators

There are several hundred variables released on the various MEPS public use data files. To assist the user in locating particular variables of interest, variable locator documents organize the many variables by concept, level of analysis, and file number.



Users may also locate Household survey variables by going to the PUF database search page and searching by the Data Elements option.


Database of The 1996 Nursing Home Component (NHC) Files


NHC files have limited availability because of confidentiality restrictions. These data are only available through the CCFS Data Center; however, file documentation is available on the NHC on-line PUF database.


Nursing Home Component Facility Level Files

At the facility level, data from the MEPS Nursing Home Component Facility Level Files include data from nursing home facilities (retirement centers, hospitals, etc.). Variables pertaining to the characteristics of the facility include information on the facility's structure; the number of beds by licensing and certification categories; ownership and chain affiliation; number of residents; special care units by type, size and residents; staffing; services routinely provided by trained providers to residents, non-residents on-site and non-residents off-site; physician practice information; and whether the facility vaccinated residents for pneumonia and influenza. Users should note that due to confidentiality restrictions, the data file is only available through the CCFS Data Center; however, file documentation is available from the NHC on-line PUF database.


Nursing Home Component Person Characteristics File

At the person (nursing home resident) level, variables describe characteristics of nursing home residents including demographics, health status, insurance coverage, and medical conditions are available. Users should note that due to confidentiality restrictions, this data is only available through the CCFS Data Center; however, file documentation is available from the NHC on-line PUF database.


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Fact Sheet


MEPSnet: A New Interactive Statistical Tool




MEPSnet was developed to provide immediate access to data from the Medical Expenditure Panel Survey (MEPS) in a nonprogramming environment. Available online, MEPSnet is quick and easy to use, allowing even novice users the ability to generate national estimates in a few seconds.



Select for PDF file (88 KB). PDF Help.




What Is MEPSnet? / MEPSnet/IC /
MEPSnet/HC / Who Uses MEPSnet? / What Questions Can MEPSnet Answer? / How Do I Use MEPSnet?





What Is MEPSnet?



MEPSnet is an online service that presents data from the Medical Expenditure Panel Survey (MEPS) in an easily used interactive format. MEPS, a survey of the Agency for Healthcare Research and Quality (AHRQ), provides nationally representative estimates of health care use, expenses, sources of payment, and insurance coverage for the U.S. population.


AHRQ releases MEPS data to the public in the form of public use data sets that need sophisticated programming resources and statistical software to account for the survey's complex design.


Because the skills and resources available to the MEPS user community vary widely, MEPSnet was developed to provide immediate access to the MEPS data in a non-programming environment. It is quick, easy to use through a series of interactive queries, and provides even the most novice user the ability to generate national estimates in a few seconds.


MEPSnet is actually a set of statistical tools: MEPSnet/IC and MEPSnet/HC. These two tools use information gathered from establishments and household respondents, respectively.




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MEPSnet/IC



The MEPSnet/IC operates on data from the MEPS Insurance Component. Users can generate establishment-level and employee-level estimates of health insurance premiums by State, size of establishment, and other establishment characteristics of interest. MEPSnet/IC leads users through a series of questions to focus on the particular estimate of interest. In addition, users can perform analyses and generate graphs that track changes over a given time period. Appropriate standard errors are also included.




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MEPSnet/HC


The MEPSnet/HC operates on data from the MEPS Household Component. Users can generate nationally representative estimates of health insurance coverage and of health care use and expenditures for various subpopulations of interest. MEPSnet/HC presents users with a variety of variables they can use in their analyses. It includes detailed documentation and frequency information for each variable.




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Who Uses MEPSnet?


Policymakers and health services researchers use MEPSnet. For example, MEPSnet/IC has been used to help policymakers at the State level:


  • To produce reports for State legislators and governors on the status of employer-sponsored health insurance in their State.
  • To provide cost estimates and otherwise inform new health insurance proposals in the State.
  • To track the effects of past changes in State health insurance policy.

But MEPSnet users are not restricted to researchers. MEPSnet is available to anyone who wants descriptive information on the Nation's use of health services.


In addition, health services researchers who are interested in using MEPS data in their analysis use MEPSnet to explore the MEPS data sets before committing the programming resources needed to perform their analyses.




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What Questions Can MEPSnet Answer?



MEPSnet/HC has been used to answer the following types of questions:


  • How do health care use and spending vary for different groups, such as the elderly, children, and women?
  • What proportion of the U.S. population has health insurance coverage? What proportion is uninsured?
  • How does health care use vary by the type of health insurance coverage held?


MEPSnet/IC has been used to answer the following types of questions:


  • What do employers spend on health insurance and how do they share those costs with their employees?
  • How do employer costs for health insurance and the types of plans offered vary by State and region?
  • What types of establishments offer health insurance and what types of coverage do they offer?



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How Do I Use MEPSnet?



MEPSnet was developed so that users can generate statistics without extensive programming resources and knowledge. It therefore consists of a series of queries that walk the user through a step-by-step process. MEPSnet users:


  1. Select the data file they want.
  2. Select the variables of interest.
  3. Can choose to recategorize the variables (e.g., combine ages to create age groups under 18 and 18 or over).
  4. Can choose to focus on a particular subpopulation.
  5. Select the specific statistics they want.

Help screens are available throughout MEPSnet.


MEPSnet is available through the MEPS Web site at www.meps.ahrq.gov.


Updates to MEPSnet and the Web site are announced via the Web sites What's New? page and through the MEPS mailing list and LISTSERV®.





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AHRQ Publication. No. 02-P017

Current as of March 2002




Internet Citation:


MEPSnet: A New Interactive Statistical Tool. Fact Sheet. AHRQ Publication No. 02-P017, March 2002. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/data/mepsnet.htm




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