Abstract
Timely, accurate and reliable estimates of the population’s health insurance status are essential inputs to policymakers to inform assessments of the population’s access to medical care and analyses of associated health care expenditures. Alternative criteria that have been used to produce annual estimates of the uninsured include the following specifications: those uninsured for a full-year, those ever uninsured during a year, and those uninsured at a specific point in time. The Medical Expenditure Panel Survey (MEPS), one of the core health care surveys in the United States, supports all three types of estimates. In this paper, a summary is provided of the survey operations, informational materials, the interviewer training and experience of the field force, and the refusal conversion techniques employed in the MEPS to maintain respondent cooperation for five rounds of interviewing, to help minimize sample attrition. The impact of nonresponse attributable to survey attrition is also assessed with respect to the national health insurance coverage estimates derived from the MEPS. The study includes an examination of the quality of the nonresponse adjustments employed to adjust for potential nonresponse bias attributable to survey attrition. The overlapping panel design of the MEPS survey is particularly well suited to inform these studies. The presentation concludes with a discussion of strategies under consideration that may yield additional improvements in the accuracy for these critical policy relevant survey estimates.
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The views expressed in this paper are those of the author and no official endorsement by the Department of Health and Human Services or the Agency for Healthcare Research and Quality is intended or should be inferred. Special thanks go to David Kashihara for his statistical programming efforts and expertise. The authors wish to thank Joel W. Cohen and Jessica Banthin (AHRQ) and Diane Makuc with NCHS/CDC, for their careful review of the manuscript and helpful comments.
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Cohen, S.B., Ezzati-Rice, T. & Yu, W. The impact of survey attrition on health insurance coverage estimates in a National Longitudinal Health Care Survey . Health Serv Outcomes Res Method 6, 111–125 (2006). https://doi.org/10.1007/s10742-006-0006-z
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DOI: https://doi.org/10.1007/s10742-006-0006-z