Health insurance coverage during a 24-month period: a comparison of estimates from two national health surveys |
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Authors: | Steven B Cohen Diane M Makuc Trena M Ezzati-Rice |
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Institution: | (1) Agency for Healthcare Research and Quality, 540 Gaither Road John M. Eisenberg Building, Rockville, MD 20850, USA;(2) Centers for Disease Control and Prevention (CDC)/National Center for Health Statistics, 3311 Toledo Rd, Hyattsville, MD 20782, USA |
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Abstract: | National estimates of the uninsured are available from multiple surveys and differ across surveys. Previous efforts to better
understand reasons for differences among these estimates have primarily focused on annual estimates. This study compares national
estimates of health insurance coverage over generally comparable 24-month time periods using two integrated Federal health-related
surveys, the Medical Expenditure Panel Survey (MEPS) and the National Health Interview Survey (NHIS) for the years 2002–2003
and replicated analyses for 2001–2002. We examine survey participants insurance status in year 1 and year 2 based on the NHIS
linked with the MEPS and also for MEPS year 1 and year 2 participants. We also examine characteristics associated with 24-month
coverage status. National estimates of the percents continuously insured did not differ significantly between the two data
sources. In contrast, the MEPS longitudinal estimate of the percent continuously uninsured was higher than the NHIS-MEPS linked
estimate whereas the MEPS longitudinal estimate of the discontinuously insured was lower than that derived from the NHIS-MEPS
linked data. Factors that help explain these differences include the non-equivalence of the time periods covered by the data
sources, modest differences in the length of time covered by the MEPS and NHIS survey instruments, and length of recall. Regression
analyses yielded highly consistent correlates of being continuously uninsured versus continuously insured for both data sources.
Regression results for discontinuous versus continuous coverage were also generally similar for both data sources. Gaining
a better understanding of the alignment in findings based on alternative data sources that support comparable analyses of
health insurance coverage helps policymakers to make the most appropriate use of resultant estimates.
The views expressed in this paper are those of the authors and no official endorsement by the Department of Health and Human
Services or the Agency for Healthcare Research and Quality or the Centers for Disease Control and Prevention is intended or
should be inferred. |
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Keywords: | Uninsured Linked designs MEPS NHIS |
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