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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]
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]
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, Health Insurance, Health Disparities, Women's Health, Prescription Drugs, Individuals with Disabilities, and the 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]
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.
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]
The six full-year files include:
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 Medical Expenditure Panel Survey is commonly the subject of analysis in articles on health policy and health services in research journals such as Health Affairs, JAMA, Health Services Research, and the New England Journal of Medicine. [23]
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]
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