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MEPS HC-206I:
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| Identifier | Description |
|---|---|
| Name | Variable name |
| Description | Variable descriptor |
| Format | Number of bytes |
| Type | Type of data: numeric (indicated by NUM) or character (indicated by CHAR) |
| Start | Beginning column position of variable in record |
| End | Ending column position of variable in record |
In general, variable names reflect the content of the variable. All variables contained on Files 1 and 2 were derived from the CAPI.
File 1 (H206IF1) or the CLNK file, contains the variables needed to link each record on the MEPS 2018 Conditions file, HC-207, with one or more records on the MEPS 2018 event files, HC-206A, and HC-206D through HC-206H. Section 3.0 contains additional information on completing this linkage.
The 10-character variable DUPERSID uniquely identifies each person represented on the file. The variable DUPERSID is the combination of the variables DUID and PID. As part of the new CAPI design, the lengths of the ID variables have changed in the file. The additional 2 bytes in the IDs resulted from adding a 2-digit panel number to the beginning of all the IDs. Analysts wishing to pool data years 2017 and 2018 should add panel numbers to the beginning of Panel 22 Year 2017 ID variables, or remove the 2-digit panel number at the beginning of Panel 22 Year 2018 ID variables to ensure they identify the same person. There may be more than one record on the CLNK file for a specific DUPERSID value.
CONDIDX is the 13-digit ID that uniquely identifies each condition for a person and corresponds to a unique record on the MEPS 2018 Conditions file, HC-207. The variable CONDIDX is the combination of the variables DUPERSID and CONDN (see HC-207 for a description of CONDN). In addition to the 2-digit panel number added in the beginning of CONDIDX, the CONDN portion of CONDIDX is one less byte (4 bytes to 3 bytes). There may be more than one record on the CLNK file for a specific CONDIDX value.
EVNTIDX is the 16-digit number that uniquely identifies each event for a person and corresponds to a unique record on one of the MEPS 2018 event files, HC-206B through HC-206H. (EVNTIDX is not included on the 2018 Prescribed Medicines event file, HC-206A; rather, on this file the variable for linking with EVNTIDX on the CLNK file is LINKIDX.) There may be more than one record on the CLNK file for a specific EVNTIDX value. As part of the new CAPI design, the length of the EVNTIDX has changed to 16 in the file. In addition to the 2-digit panel number added in the beginning, a 2-digit event type number is added to the end. The event type number indicates the type of event record and has been rolled up into the following values:
CLNKIDX is the 29-digit number that uniquely identifies each record on the CLNK file and is the combination of CONDIDX + EVNTIDX. There is just one record on this file for each value of CLNKIDX, i.e., each unique combination of CONDIDX + EVNTIDX. Due to the changes in length of CONDIDX and EVNTIDX, CLNKIDX is now 29 bytes.
The variable EVENTYPE indicates the type of event record, and has the following values:
PANEL is a constructed variable used to specify the panel number for the interview in which the condition was reported. PANEL will indicate either Panel 22 or Panel 23. Panel 22 is the panel that started in 2017, and Panel 23 is the panel that started in 2018. Beginning in 2018, the panel number is included as the first two digits of the DUID and DUPERSID.
File 2 (H206IF2) or the RXLK file, contains the variables needed to link each record on the MEPS 2018 Prescribed Medicines file, HC-206A, with one or more records on the MEPS 2018 event files, HC-206B and HC-206D through HC-206G. Section 3.0 contains additional information on completing this linkage.
The 10-character variable DUPERSID uniquely identifies each person represented on the file. The variable DUPERSID is the combination of the variables DUID and PID. As part of the new CAPI design, the length of the ID variables has changed in the file. The additional 2 bytes in the IDs resulted from adding a 2-digit panel number to the beginning of all the IDs. There may be more than one record on the RXLK file for a specific DUPERSID value.
EVNTIDX is the 16-digit number that uniquely identifies each event for a person and corresponds to a unique record on one of the MEPS 2018 event files, HC-206B through HC-206G. There may be more than one record on the RXLK file for a specific EVNTIDX value. As part of the new CAPI design, the length of the EVNTIDX has changed to 16 in the file. In addition to the 2-digit panel number added in the beginning, a 2-digit event type number, 01, is added to the end.
LINKIDX is the 16-digit number that identifies the record(s) on the prescribed medicines file, HC-206A that link to an event record. There may be more than one record on the RXLK file for a specific LINKIDX value, and there may be more than one record on the HC-206A file for a specific LINKIDX value. As part of the new CAPI design, the length of the LINKIDX has changed to 16 in the file. In addition to the 2-digit panel number added in the beginning, a 2-digit event type number, 03, is added to the end.
RXLKIDX is the 32-digit number that uniquely identifies each record on the RXLK file, and is the combination of EVNTIDX + LINKIDX. There is just one record on this file for each value of RXLKIDX, i.e., each unique combination of EVNTIDX + LINKIDX. Due to the changes in length of EVNTIDX and LINKIDX, RXLKIDX is now 32 bytes.
The variable EVENTYPE indicates the type of event record and has the following values:
For 1996-2004, records for purchases of insulin and diabetic supplies in a round were included in the Other Medical Expenses event files. Beginning with the 2005 file, these records are not included in the Other Medical Expenses file because the expenditures have always been included in the Prescribed Medicines file. As a consequence, there are no records in this file where the variable EVENTYPE = 6, the value used in 1996-2004 to identify OMED type of event record. Beginning in 2018, prescription medication is no longer asked for dental visit events. Therefore, there are no records in this file where the variable EVENTYPE = 5.
PANEL is a constructed variable used to specify the panel number for the interview in which the condition was reported. PANEL will indicate either Panel 22 or Panel 23. Panel 22 is the panel that started in 2017, and Panel 23 is the panel that started in 2018. Beginning in 2018, the panel number is included as the first two digits of the DUID and DUPERSID.
Table 1 included with this document contains the MEPS 2018 Condition-Event Frequencies. The frequency tables contain unweighted and weighted counts of records on the MEPS 2018 event files, HC-206A through HC-206H, for each of the condition codes contained on the MEPS 2018 Conditions file, HC-207.
Beginning in 2018, Clinical Classification Software Refined (CCSR) codes will be used alongside ICD-10-CM diagnosis codes to group medical conditions into clinically meaningful categories. One ICD-10-CM diagnosis code may map to up to five CCSR categories. However, for the purposes of MEPS, one ICD-10-CM diagnosis code may map to up to three CCSR categories (CCSR1X, CCSR2X, CCSR3X) using the v2019.1 release of the CCSR for ICD-10-CM diagnoses. The CCSR categories are listed in alphabetical order and do not indicate a primary and secondary diagnosis. For more information on CCSR, visit the user guide for CCSR.
This section provides information on using each of the two HC-206I files, RXLK and CLNK, to link with the files contained in MEPS releases HC-207 and HC-206A, HC-206B, and HC-206D through HC-206H. The linking procedure is described using several examples of deriving MEPS-based estimates. Also included in this section are several caveats related to using the RXLK and CLNK files.
This example calculates the total expenditures for prescribed medicines associated with office-based medical provider visits for asthma, using these files: the Conditions file (HC-207), the CLNK file (HC-206IF1), the office-based medical provider visit event file (HC-206G), the RXLK file (HC-206IF2), and the prescribed medicines event file (HC-206A). It includes the following major steps:
Attachment 1 contains a copy of the SAS job for this
example.
Attachment 2 contains a copy of the STATA job for this
example.
This example calculates the total expenditure for prescribed medicines associated with asthma, using the Conditions file (HC-207), the CLNK file (HC-206IF1) and the prescribed medicines event file (HC-206A). It includes the following major steps:
Attachment 1 contains a copy of the SAS job for this example.
Attachment 2 contains a copy of the STATA job for this example.
This example calculates the total expenditures for office-based medical provider visits associated with asthma, using the Conditions file (HC-207), the CLNK file (HC-206IF1) and the office-based medical provider visits event file (HC-206G). It includes the following major steps:
Attachment 1 contains a copy of the SAS job for this example.
Attachment 2 contains a copy of the STATA job for this example.
When using the CLNK file, analysts should keep in mind that (1) conditions are self-reported and (2) there may be multiple conditions associated with an event. Users should also note that not all events link to the Conditions file.
When using the RXLK file, analysts should keep in mind that one event record can link to more than one prescribed medicine record. Conversely, a prescribed medicine record may link to more than one event record in the same event file and/or more than one event record in other event files. When this occurs, it is up to the analyst to determine how the prescribed medicine expenditures should be allocated among those medical events.
Data from this file can be used alone or in conjunction with other files for different analytic purposes. Each MEPS panel can also be linked back to the previous years’ National Health Interview Survey public use data files. For information on obtaining MEPS/NHIS link files please see the MEPS website.
MEPS began in 1996, and the utility of the survey for analyzing health care trends expands with each additional year of data; however, there are a variety of methodological and statistical considerations when examining trends over time using MEPS. Tests of statistical significance should be conducted to assess the likelihood that observed trends may be attributable to sampling variation. The length of time being analyzed should also be considered. In particular, large shifts in survey estimates over short periods of time (e.g. from one year to the next) that are statistically significant should be interpreted with caution, unless they are attributable to known factors such as changes in public policy, economic conditions, or MEPS survey methodology. For example, as a result of improved methods for collecting priority conditions data implemented in 2007, prevalence measures prior to 2007 are not comparable to those from 2007 and beyond for many conditions. Users should refer to the documentation for the conditions file (HC-207) for details.
With respect to methodological considerations, in 2013 MEPS introduced an effort to obtain more complete information about health care utilization from MEPS respondents with full implementation in early 2014. This effort likely resulted in improved data quality and a reduction in underreporting in 2014, but could have some modest impact on analyses involving trends in utilization across years. The aforementioned change in the NHIS sample design in 2016 could also potentially affect trend analyses. The new NHIS sample design is based on more up-to-date information related to the distribution of housing units across the U.S. As a result, it can be expected to better cover the full U.S. civilian, noninstitutionalized population, the target population for MEPS, as well as many of its subpopulations. Better coverage of the target population helps to reduce the potential for bias in both NHIS and MEPS estimates.
Another change with the potential to affect trend analyses involved modifications to the MEPS instrument design and data collection process. These were introduced in the Spring of 2018 and thus affected data beginning with Round 1 of Panel 23, Round 3 of Panel 22, and Round 5 of Panel 21. Since the Full Year 2017 PUFs were established from data collected in Rounds 1-3 of Panel 22 and Rounds 3-5 of Panel 21, they reflected two different instrument designs. In order to mitigate the effect of such differences within the same full year file, the Panel 22, Round 3 data and the Panel 21 Round 5 data were transformed to make them as consistent as possible with data collected under the previous design. The changes in the instrument were designed to make the data collection effort more efficient and easy to administer. In addition, expectations were that data on some items, such as those related to health care events, would be more complete with the potential for identifying more events. Increases in service use reported since the implementation of these changes are consistent with these expectations.
There are also statistical factors to consider in interpreting trend analyses. Looking at changes over longer periods of time can provide a more complete picture of underlying trends. Analysts may wish to consider using techniques to smooth or stabilize analyses of trends using MEPS data such as comparing pooled time periods (e.g. 1996-97 versus 2011-12), working with moving averages or using modeling techniques with several consecutive years of MEPS data to test the fit of specified patterns over time. Finally, researchers should be aware of the impact of multiple comparisons on Type I error. Without making appropriate allowance for multiple comparisons, undertaking numerous statistical significance tests of trends increases the likelihood of concluding that a change has taken place when one has not.
Panel-specific longitudinal files are available for downloading in the data section of the MEPS Web site. For each panel, the longitudinal file comprises MEPS survey data obtained in Rounds 1 through 5 of the panel and can be used to analyze changes over a two-year period. Variables in the file pertaining to survey administration, demographics, employment, health status, disability days, quality of care, patient satisfaction, health insurance, and medical care use and expenditures were obtained from the MEPS full-year Consolidated files from the two years covered by that panel.
For more details or to download the data files, please see Longitudinal Data Files at the AHRQ website.
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