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Health Serv Res. 2009 Oct;44(5 Pt 1):1679-700. doi: 10.1111/j.1475-6773.2009.00995.x. Epub 2009 Jul 13.

Validating household reports of health care use in the medical expenditure panel survey.

Author information

  • 1Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Rockville, MD 20850, USA. samuel.zuvekas@ahrq.hhs.gov

Abstract

BACKGROUND:

The Medical Expenditure Panel Survey (MEPS) is a widely used nationally representative survey of health care use and expenditures. Numerous studies raise concerns that use is underreported in household surveys.

OBJECTIVE:

To assess the quality of household reports in the MEPS and the impact of misreporting on descriptive and behavioral analyses.

RESEARCH DESIGN:

Participants in MEPS with Medicare coverage during 2001-2003 were matched to their Medicare enrollment and claims data (4,045 person-year observations). Household reports of Medicare-covered services for the matched sample were validated against Medicare claims. Standard models of the determinants of health care utilization were estimated with both MEPS and claims-based utilization measures.

MEASURES:

In-person interviews with household informants obtained data on hospital inpatient, emergency department (ED), and office-based visits. Comparable measures were created from the claims.

RESULTS:

In the validation sample, households accurately reported inpatient stays (agreement rate=0.96, kappa=0.89) and number of nights (Lin's concordance statistic=0.88). Households underreported ED visits by one-third (Lin's concordance statistic=0.51) and office visits by 19 percent (Lin's concordance statistic=0.67).

CONCLUSIONS:

Household respondents in the validation sample accurately report inpatient hospitalizations but underreport ED and office visits. Behavioral analyses are largely unaffected because underreporting cuts across all sociodemographic groups.

PMID:
19619249
PMCID:
PMC2754554
DOI:
10.1111/j.1475-6773.2009.00995.x
[PubMed - indexed for MEDLINE]
Free PMC Article
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