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MEPS HC-069: 2002 Medical Conditions
December 2004
Agency for Healthcare Research and Quality
Center for Financing, Access, and Cost Trends
540 Gaither Road
Rockville, MD 20850
(301) 427-1406
Table of Contents
A. Data Use Agreement
B. Background
1.0 Household Component
2.0 Medical Provider Component
3.0 Insurance Component
4.0 Survey Management
C. Technical and Programming Information
1.0 General Information
2.0 Data File Information
2.1 Using MEPS Data for Trend and Longitudinal Analysis
2.2 Codebook Structure
2.3 Reserved Codes
2.4 Codebook Format
2.5 Variable Naming
2.6 File Contents
2.6.1 Identifier Variables (DUID-CONDRN)
2.6.2 Medical Condition Variables (PRIOLIST-CCCODEX)
2.6.3 Utilization Variables (OBNUM-RXNUM)
3.0 Sample Weight (PERWT02F)
3.1 Overview
3.2 Details on Person Weight Construction
3.2.1 MEPS Panel 6 Weight
3.2.2 MEPS Panel 7 Weight
3.2.3 The Final Weight for 2002
3.2.4 Coverage
4.0 Merging MEPS Data Files
References
Appendix 1: Variable-Source Crosswalk
Appendix 2: Condition, Procedure and Clinical
Classification Code Frequencies
Appendix 3:
Clinical Classification Code to ICD-9-CM Code Crosswalk
Appendix 4: List of Priority Conditions
A. Data Use Agreement
Individual identifiers have been removed from the
micro-data contained in these files. Nevertheless, under sections 308 (d) and
903 (c) of the Public Health Service Act (42 U.S.C. 242m and 42 U.S.C. 299 a-1),
data collected by the Agency for Healthcare Research and Quality (AHRQ) and/or
the National Center for Health Statistics (NCHS) may not be used for any purpose
other than for the purpose for which they were supplied; any effort to determine
the identity of any reported cases is prohibited by law.
Therefore in accordance with the above referenced Federal
Statute, it is understood that:
1. No one is to use the data in this data set in
any way except for statistical reporting and analysis; and
2. If the identity of any person or establishment
should be discovered inadvertently, then (a) no use will be made of
this knowledge, (b) the Director Office of Management AHRQ will be
advised of this incident, (c) the information that would identify any
individual or establishment will be safeguarded or destroyed, as
requested by AHRQ, and (d) no one else will be informed of the
discovered identity; and
3. No one will attempt to link this data set with
individually identifiable records from any data sets other than the
Medical Expenditure Panel Survey or the National Health Interview
Survey
By using these data you signify your agreement to comply
with the above stated statutorily based requirements with the knowledge that
deliberately making a false statement in any matter within the jurisdiction of
any department or agency of the Federal Government violates Title 18 part 1
Chapter 47 Section 1001 and is punishable by a fine of up to $10,000 or up to 5
years in prison.
The Agency for Healthcare Research and Quality requests
that users cite AHRQ and the Medical Expenditure Panel Survey as the data source
in any publications or research based upon these data.
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B. Background
The Medical Expenditure Panel Survey (MEPS) provides
nationally representative estimates of health care use, expenditures, sources of
payment, and insurance coverage for the U.S. civilian non-institutionalized
population. MEPS is cosponsored by the Agency for Healthcare Research and
Quality (AHRQ) and the National Center for Health Statistics (NCHS).
MEPS is a family of three surveys. The Household Component
(HC) is the core survey and forms the basis for the Medical Provider Component (MPC)
and part of the Insurance Component (IC). Together these surveys yield
comprehensive data that provide national estimates of the level and distribution
of health care use and expenditures, support health services research, and can
be used to assess health care policy implications.
MEPS is the third in a series of national probability
surveys conducted by AHRQ on the financing and use of medical care in the United
States. The National Medical Care Expenditure Survey (NMCES, also known as
NMES-1) was conducted in 1977 and the National Medical Expenditure Survey
(NMES-2) in 1987. Since 1996, MEPS continues this series with design
enhancements and efficiencies that provide a more current data resource to
capture the changing dynamics of the health care delivery and insurance system.
The design efficiencies incorporated into MEPS are in
accordance with the Department of Health and Human Services (DHHS) Survey
Integration Plan of June 1995, which focused on consolidating DHHS surveys,
achieving cost efficiencies, reducing respondent burden, and enhancing
analytical capacities. To advance these goals, MEPS includes linkage with the
National Health Interview Survey (NHIS) - a survey conducted by NCHS from which
the sample for the MEPS HC is drawn - and enhanced longitudinal data collection
for core survey components. The MEPS HC augments NHIS by selecting a sample of
NHIS respondents, collecting additional data on their health care expenditures,
and linking these data with additional information collected from the
respondents’ medical providers, employers, and insurance providers.
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1.0 Household Component
The MEPS HC, a nationally representative survey of the
U.S. civilian non-institutionalized population, collects medical expenditure
data at both the person and household levels. The HC collects detailed data on
demographic characteristics, health conditions, health status, use of medical
care services, charges and payments, access to care, satisfaction with care,
health insurance coverage, income, and employment.
The HC uses an overlapping panel design in which data are
collected through a preliminary contact followed by a series of five rounds of
interviews over a 2 ½-year period. Using computer-assisted personal interviewing
(CAPI) technology, data on medical expenditures and use for two calendar years
are collected from each household. This series of data collection rounds is
launched each subsequent year on a new sample of households to provide
overlapping panels of survey data and, when combined with other ongoing panels,
will provide continuous and current estimates of health care expenditures.
The sampling frame for the MEPS HC is drawn from
respondents to NHIS. NHIS provides a nationally representative sample of the
U.S. civilian non-institutionalized population, with oversampling of Hispanics
and blacks.
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2.0 Medical Provider Component
The MEPS MPC supplements and/or replaces information on
medical care events reported in the MEPS HC by contacting medical providers and
pharmacies identified by household respondents. The MPC sample includes all home
health agencies and pharmacies reported by HC respondents. Office-based
physicians, hospitals, and hospital physicians are also included in the MPC but
may be subsampled at various rates, depending on burden and resources, in
certain years.
Data are collected on medical and financial
characteristics of medical and pharmacy events reported by HC respondents. The
MPC is conducted through telephone interviews and record abstraction.
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3.0 Insurance Component
The MEPS IC collects data on health insurance plans
obtained through private and public-sector employers. Data obtained in the IC
include the number and types of private insurance plans offered, benefits
associated with these plans, premiums, contributions by employers and employees,
eligibility requirements, and employer characteristics.
Establishments participating in the MEPS IC are selected
through three sampling frames:
- A list of employers or other insurance providers
identified by MEPS HC respondents who report having private health insurance
at the Round 1 interview.
- A Bureau of the Census list frame of private sector
business establishments.
- The Census of Governments from the Bureau of the Census.
To provide an integrated picture of health insurance, data
collected from the first sampling frame (employers and insurance providers
identified by MEPS HC respondents) are linked back to data provided by those
respondents. Data from the two Census Bureau sampling frames are used to produce
annual national and state estimates of the supply and cost of private health
insurance available to American workers and to evaluate policy issues pertaining
to health insurance. National estimates of employer contributions to group
insurance from the MEPS IC are used in the computation of Gross Domestic Product
(GDP) by the Bureau of Economic Analysis.
The MEPS IC is an annual survey. Data are collected from
the selected organizations through a prescreening telephone interview, a mailed
questionnaire, and a telephone follow-up for nonrespondents.
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4.0 Survey Management
MEPS data are collected under the authority of the Public
Health Service Act. They are edited and published in accordance with the
confidentiality provisions of this act and the Privacy Act. NCHS provides
consultation and technical assistance.
As soon as data collection and editing are completed, the
MEPS survey data are released to the public in staged releases of summary
reports, microdata files and compendiums of tables. Data are released through
MEPSnet, an online interactive tool developed to give users the ability to
statistically analyze MEPS data in real time. Summary reports and compendiums of
tables are released as printed documents and electronic files. Microdata files
are released on electronic files.
Selected printed documents are available through the AHRQ
Publications Clearinghouse. Write or call:
AHRQ Publications Clearinghouse
Attn: (publication number)
P.O. Box 8547
Silver Spring, MD 20907
800-358-9295
410-381-3150 (callers outside the United States only)
888-586-6340 (toll-free TDD service; hearing impaired only)
Be sure to specify the AHRQ number of the document you are
requesting.
Additional information on MEPS is available from the MEPS
project manager or the MEPS public use data manager at the Center for Financing,
Access, and Cost Trends, Agency for Healthcare Research and Quality, 540 Gaither
Road, Rockville, MD 20850 (301-427-1406).
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C. Technical and Programming Information
1.0 General Information
This documentation describes the data contained in MEPS
Public Use Release HC-069, which is one in a series of public use data files to
be released from the 2002 Medical Expenditure Panel Survey Household Component (MEPS
HC).
Released in ASCII (with related SAS and SPSS programming
statements) and SAS formats, this public use file provides
information on household-reported medical conditions collected on a nationally
representative sample of the civilian noninstitutionalized population of the
United States for calendar year 2002 MEPS HC.
The following documentation offers a brief overview of the
types and levels of data provided and the content and structure of the files. It
contains the following sections:
Data File Information
Survey Sample Information
Merging MEPS Data Files
Appendices
Variable to Source Crosswalk
Detailed ICD-9-CM Condition, Procedure, and Clinical Classification Code
Frequencies
Clinical Classification Code to ICD-9-CM Code Crosswalk
List of Priority Conditions
A codebook of all the variables included in the 2002
Medical Conditions File is provided in separate files (H69CB.PDF and H69CB.ASP).
The Readme file contains the programming information.
For more information on MEPS survey design, see Cohen
1997; Cohen 1997; and Cohen 1996. A copy of the survey instrument used to
collect the information on this file is available on the MEPS web site: http://www.meps.ahrq.gov.
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2.0 Data File Information
This file contains 120,795 records. Each record represents
one medical condition reported by a household survey respondent who resides in
an eligible responding household and who has a positive person or family weight.
Records meeting one of the following criteria are included on the file.
In Panel 7:
- All Round 1 and Round 2 conditions;
- Round 3 conditions that are linked to a 2002 event;
- Round 3 conditions that were on the priority list, not
due to an accident or injury, and began before 2003;
- Round 3 conditions that were due to an accident or
injury and began before 2003
- Round 3 conditions where fifty percent or more of
person’s reference period occurred in 2002.
In Panel 6:
- All Round 4 and Round 5 conditions;
- Round 1, Round 2, and Round 3 conditions that meet at
least one of the following two criteria:
- The condition is linked to a 2002 event;
- The condition is a priority condition;
- Round 3 conditions that are injuries;
- Round 3 conditions that were not previously delivered in
the FY 2001 Conditions PUF (HC-061). This includes:
- Round 3 conditions created after the delivery of the
FY 2001 Conditions File due to Round 4 and Round 5 comments processing;
- Round 3 conditions where the person did not have a
positive person or family weight in FY 2001 but has a positive person or
family weight in FY 2002;
- Round 3 conditions where fifty percent or more of
person’s reference period occurred in 2002.
For each variable on the file, the codebook provides both
weighted and unweighted frequencies. Because the conditions identified in this
file are derived from self-reports, these data cannot be used to make estimates
of disease, prevalence of health conditions, or mortality/morbidity.
Data from this file can be merged with 2002 MEPS
person-level data using DUPERSID to append person-level characteristics such as
demographic or health insurance characteristics to each record (see Section 4.0
for details). Since each record represents a single condition reported by a
household respondent, some household respondents may have multiple medical
conditions and thus will be represented on multiple records on this file. Other
household respondents may have reported no medical conditions and thus will have
no records on this file. Still other respondents may have reported a medical
condition that did not meet the criteria above and thus will have no records on
this file. Data from this file also can be merged to 2002 MEPS Event Files
(HC-067H, HC-067D, HC-067G, HC-067F, HC-067E, and HC-067A) by using the link
files provided in HC-067I, (see HC-067I for details).
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2.1 Using MEPS Data for Trend and Longitudinal Analysis
MEPS began in 1996 and several annual data files have been
released. As more years of data are produced, MEPS will become increasingly
valuable for examining health care trends. However, it is important to consider
a variety of factors when examining trends over time using MEPS. Statistical
significance tests should be conducted to assess the likelihood that observed
trends are attributable to sampling variation. MEPS expenditure estimates are
especially sensitive to sampling variation due to the underlying skewed
distribution of expenditures. For example, 1 percent of the population accounts
for about one-quarter of all expenditures. The extent to which observations with
extremely high expenditures are captured in the MEPS sample varies from year to
year (especially for smaller population subgroups), which can produce
substantial shifts in estimates of means or totals that are simply an artifact
of the sample(s). 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 or MEPS survey methodology. 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 trend
analyses of MEPS data such as pooling time periods for comparison (e.g. 1996-97
versus 1998-99), 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 because performing numerous statistical significance
tests of trend increases the likelihood of inappropriately concluding a change
is statistically significant.
The records on this file can be linked to all other 2002
MEPS-HC public use data sets by the sample person identifier (DUPERSID).
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2.2 Codebook Structure
The codebook and data file sequence lists variables in the
following order:
Unique person identifiers
Unique condition identifiers
Medical condition variables
Utilization variables
Weight and variance estimation variables
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2.3 Reserved Codes
The following reserved code values are used:
| VALUE |
DEFINITION |
| -1 INAPPLICABLE |
Question was not asked due to skip pattern |
| -7 REFUSED |
Question was asked and respondent refused to answer question |
| -8 DK |
Question was asked and respondent did not know answer |
| -9 NOT ASCERTAINED |
Interviewer did not record the data |
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2.4 Codebook Format
This codebook describes an ASCII data set and provides the
following programming identifiers for each variable:
| Identifier |
Description |
| Name |
Variable name (maximum of 8 characters) |
| Description |
Variable descriptor (maximum of 40 characters) |
| 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 |
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2.5 Variable Naming
In general, variable names reflect the content of the
variable, with an 8-character limitation. For questions asked in a specific
round, the end digit in the variable name reflects the round in which the
question was asked. Edited variables end in an "X" and are so noted in the
variable label. (CONDIDX, which is an encrypted identifier variable, also ends
in an "X".)
Variables contained in this delivery were derived either
from the questionnaire itself or from the CAPI. The source of each variable is
identified in Appendix 1 entitled "Variable to Source Crosswalk." Sources for
each variable are indicated in one of three ways: (1) variables derived from
CAPI or assigned in sampling are so indicated; (2) variables collected at one or
more specific questions have those numbers and questionnaire sections indicated
in the "SOURCE" column; and (3) variables constructed from multiple questions
using complex algorithms are labeled "Constructed" in the "SOURCE" column.
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2.6 File Contents
2.6.1 Identifier Variables (DUID-CONDRN)
The definitions of Dwelling Units (DUs) and Group Quarters
in the MEPS HC are generally consistent with the definitions employed for the
National Health Interview Survey (NHIS). The dwelling unit ID (DUID) is a
five-digit random number assigned after the case was sampled for MEPS. The
person number (PID) uniquely identifies each person within the dwelling unit.
The variable DUPERSID uniquely identifies each person represented on the file
and is the combination of the variables DUID and PID. CONDN indicates the
condition number as it was reported during the interview for an individual
respondent (e.g., condition number 1, 2, 3, etc.) plus a control digit. The
current range for CONDN is 10-496 and the largest range of records for any
person on the file is 1 - 38. Note that this discrepancy is expected, as
condition numbers are not sequentially assigned by the CAPI. In other words, if
CONDN is set to 10 for a person's first condition, then CONDN might be set to 17
for the person's second condition. CONDIDX uniquely identifies each condition
(i.e., each record on the file) and is the combination of DUPERSID and the last
four digits of a person's CONDID.
PANEL02 is a constructed variable used to specify the
panel number for the interview in which the condition was reported. PANEL02 will
indicate either Panel 6 or Panel 7.
CONDRN indicates the round in which the condition was first reported. For a small number of cases, conditions that actually began
in an earlier round were not reported by respondents until subsequent rounds of
data collection. During file construction, editing was performed for these cases
in order to reconcile the round in which a condition began and the round in
which the condition was first reported.
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2.6.2 Medical Condition Variables (PRIOLIST-CCCODEX)
This file contains variables describing medical conditions
reported by respondents in several sections of the MEPS questionnaire, including
the Condition Enumeration section, and all questionnaire sections collecting
information about health provider visits, prescription medications, and
disability days (see Variable-Source Crosswalk in Appendix 1 for details).
Priority Conditions and Injuries
Certain conditions were a priori designated as "priority
conditions" (PRIOLIST=1) due to their prevalence, expense, or relevance to
policy. Some were long-term life-threatening conditions, such as cancer,
diabetes, emphysema, high cholesterol, HIV/AIDS, hypertension, ischemic heart
disease, and stroke. Others were chronic manageable conditions, including
arthritis, asthma, gall bladder disease, stomach ulcers, and back problems of
any kind. In addition, Alzheimer’s disease or other dementias, as well as
depression and anxiety disorders, were included in the priority list. For a
complete listing of "priority conditions" see Appendix 4. Priority conditions
were identified as such in the field by MEPS interviewers. Occasionally,
priority conditions were not identified as such due to interviewer
misinterpretation. Consequently, these records are missing the follow-up
questions described below. Likewise, some conditions were inaccurately
identified as priority conditions. These records do have follow-up questions
even though they are not priority conditions.
When a condition was first mentioned, respondents were
asked whether it was due to an accident or injury (INJURY=1). Some injuries are
also priority conditions (e.g. back pain).
Date Priority Condition Began/Accident Occurred
The date a priority condition began (CONDBEGD, CONDBEGM,
CONDBEGY) is collected only for conditions that appear on the priority list and
are not accident/injury conditions. The date an accident or injury occurred (ACCDENTD,
ACCDENTM, ACCDENTY) is collected only for accident/injury conditions, including
accident/injury conditions that are also priority conditions.
Round-Specific Questions for Priority Conditions and
Injuries
When a respondent first reported a condition on the
priority list (PRIOLIST=1) or a condition caused by an injury (INJURY=1), the
interviewer asked a series of questions regarding health care utilization for
that condition and the effect of that condition on the person’s overall health.
The names of these variables end in 1, 2, 3, 4, or 5 indicating the round in
which they were asked. The following questions were asked in the round in which
the respondent first reported a priority condition or a condition resulting from
an injury:
- Whether the respondent ever saw or talked to a doctor
about the condition (SEEDREV1 – SEEDREV5).
- Whether the latest time a doctor was seen for this
condition was before or after the beginning of the reference period for the
interview round (LSTSAW1). This question was asked only in Round 1.
- Whether the person was still being treated for the
condition (STILTR1-STILTR5).
- How seriously the condition affected the person’s
overall health and well-being since it began (OVRALL1-OVRALL5).
- Whether the person with the condition provided the
information himself/herself, versus the condition being reported by another
household member (WHOTYP1 – WHOTYP5).
- Whether the health care provider recommended further
treatment or consultation for the condition (FURTCA1 – FURTCA5).
- How much of the recommended follow-up care the person
received for the condition (all, some, none, or still being treated)
(FOLOCA1 – FOLOCA5).
- Whether the person saw or talked to a doctor about the
condition during the reference period (SEEDREF1 – SEEDREF5). This variable
was constructed for priority conditions only.
When a respondent reported a condition that resulted from
an accident or injury (INJURY=1), the following information was obtained from
respondents during the round in which the injury was first reported:
- Whether the accident/injury occurred at work (ACCDNWRK)
– respondents aged 15 and younger were not asked this question and the
condition was coded ACCDNWRK = -1;
- Where the accident/injury happened (ACDNTLOC);
- If the accident/injury occurred at home, was it inside
or outside the house (INOUTHH);
- Whether the accident involved a motor vehicle, gun,
weapon other than a gun, poison, fire, drowning or near-drowning, sports
injury, a non-sports related fall, something
else (VEHICLE, GUN, WEAPON, POISON, FIREBURN, DROWN, SPORTS, FALL, ACDNTOTH);
- Whether the person has fully recovered from the
accident/injury (RECOVER).
For priority conditions only, additional information was
obtained in rounds subsequent to the one in which the condition was first
reported. This information was obtained only if there was an event, a prescribed
medication, or a disability day associated with the condition in that round. If
this occurred, the condition was "selected" for follow-up questions for the
round.
For priority conditions selected in rounds after they were
first reported, the following questions were asked in that round:
- Whether the respondent saw or talked to a doctor about
the condition since the start of the reference period (SEEDREV1-SEEDREV5)
- Whether the person was still being treated for the
condition (STILTR1 – STILTR5);
- How seriously the condition affected the person’s
overall health and well-being since the start of the reference period.
(OVRALL1 – OVRALL5);
- Whether the person with the condition provided the
information himself/herself, versus the condition being reported by another
household member (WHOTYP1 – WHOTYP5);
- Whether the person saw or talked to a doctor about the
condition during the reference period (SEEDREF1 – SEEDREF5).
The variable, AFCOND, which indicates that one of the
selected or reported health conditions is related to service in the Armed Forces
of the United States, was included on the 2001 Conditions File but will be
dropped from the file beginning in 2002.
Treatment of Data from Rounds Not Occurring in 2002
For Panel 6, Rounds 1 and 2 occurred in 2001 and
conditions reported during these rounds are not included on this file unless the
condition was identified as a priority condition (see the discussion of PRIORFLG
below) or was related to a 2002 event. Note that if, in Rounds 3, 4, and 5 of
Panel 6, the person "selects" a Round 1 or 2 condition as the reason for a
reported disability day, this condition does not appear on the 2002 file unless
it is also a priority condition or is related to a 2002 event. For Panel 7,
Rounds 4 and 5 occurred in 2003 and conditions reported during these rounds are
not included on this file. Therefore, round-specific variables for Rounds 1 and
2 of Panel 6 are assigned an inapplicable code (-1) on all of the condition
records for respondents in Panel 6, and round-specific variables for Rounds 4
and 5 of Panel 7 are assigned an inapplicable code (-1) on all of the condition
records for respondents in Panel 7. Round-specific data for Rounds 4 and 5
pertain only to Panel 6; round-specific data for Rounds 1 and 2 pertain only to
Panel 7, and both panels provide data from Round 3. (Note: Use PANEL02 to
identify whether Round 3 variables were collected in Panel 6 or Panel 7.)
Conditions in this 2002 file first reported in Rounds 1 or
2 of Panel 6 that are priority conditions OR conditions resulting from an injury
have round-specific data for those rounds included on the 2001 Medical
Conditions File (HC-061). The variables PRIORFLG and INJURFLG indicate if the
condition is "Not a priority/injury condition" (0), if "Additional information
is included on the 2001 Medical Conditions File" (1), or if "All priority/injury
information is included on the current file" (2).
Note: Priority conditions are generally chronic
conditions. Even though a respondent may not have reported an event, a
prescribed medicine, or a disability day in
2002 due to the condition, analysts should consider that the respondent is
probably still experiencing the condition. If a Panel 6 respondent reported a
priority condition in Round 1 or 2 and did not have an event, a prescribed
medicine, or a disability day for the condition in Round 3, 4, or 5,
round-specific variables for Rounds 3, 4, and 5 are coded as –1. The only
information provided on the current 2002 file for such conditions are the
ICD9CODX, ICD9PROX, CCCODEX, and non-round-specific variables. These records are identified by PRIORFLG=1. Round-specific data from
Rounds 1 and 2 for these records are available in the 2001 Medical Conditions
File.
Rounds in which Conditions Were Reported/Selected (CRND1 –
CRND5)
A set of constructed variables (CRND1 – CRND5) indicates
the round in which the condition was first reported, and for subsequent rounds,
the round(s) in which an event, prescription medication, or disability day
occurred due to the condition. For example, consider a condition for which CRND1
= 0, CRND2 = 1, and CRND3 = 1. This sequence of CRND indicators on a condition
record implies that the condition was not present during Round 1 (CRND1 = 0),
was first mentioned during Round 2, and was associated with a medical event,
prescribed medicine, or disability day during Round 3. CRND1 – CRND5 are not
applicable for most pregnancies, prenatal visits, or deliveries due to the
questionnaire design.
Disability Flag Variables
This file contains three flag variables indicating whether
a condition is associated with a missed work day (MISSWORK), a missed school day
(MISSSCHL), or a day spent in bed (INBEDFLG). Due to the MEPS instrument design,
there is no link indicating the specific number of disability days
associated with a particular medical condition.
Diagnosis and Procedure Codes
The medical conditions and procedures reported by the
Household Component respondent were recorded by the interviewer as verbatim
text, which were then coded by professional coders to fully-specified ICD-9-CM
codes, including medical condition and V codes (see Health Care Financing
Administration, 1980). Although codes were verified and error rates did not
exceed 2.5 percent for any coder, analysts should not presume this level of
precision in the data; the ability of household respondents to report condition
data that can be coded accurately should not be assumed (see Cox and Iachan, 1987; Edwards, et al, 1994; and Johnson and Sanchez,
1993).
In order to preserve respondent confidentiality, nearly
all of the condition codes provided on this file (ICD9CODX) have been collapsed
from fully-specified codes to 3-digit code categories. Table 1 in Appendix 2
provides unweighted and weighted frequencies for all ICD-9-CM condition code
values reported on the file. In this table, values that reflect this collapsing
have an asterisk in the label indicating that the 3-digit category includes all
the subclassifications within that category. For example, the ICD9CODX value of
034 "Strep Throat/Scarlet Fev *" includes the fully-specified subclassifications
034.0 and 034.1; the value 296 "Affective Psychoses*" includes the
fully-specified subclassifications 296.0 through 296.99. Less than 1 percent of the records on this file were edited further by collapsing two or more
3-digit codes into one 3-digit code.
Similarly, most of the procedure codes (ICD9PROX) were
collapsed from fully-specified codes to 2-digit category codes. Table 2 in
Appendix 2 provides unweighted and weighted frequencies for ICD9PROX, and this
type of collapsing is identified by an asterisk in the variable label. For
example, the ICD9PROX value of 81 "Joint Repair*" includes subclassifications
81.0 through 81.99. Less than 1 percent of records were further edited to
combine two or more 2-digit categories.
Users should note that because of the design of the
survey, most deliveries (i.e., births) are coded as pregnancies. For more
accurate estimates for deliveries, analysts should use RSNINHOS "Reason Entered
Hospital" found on the Hospital Inpatient Stays Public Use File (HC-067D).
Conditions and procedures were reported in the same
sections of the HC questionnaire (see Variable-Source Crosswalk in Appendix 1).
Labels for all values of the variables ICD9CODX and ICD9PROX, as shown in Tables
1 and 2, are provided in the SAS programming statements included in this release
(see the H69SU.TXT file).
Clinical Classification Codes
ICD-9-CM condition codes have been aggregated
into clinically meaningful categories that group similar conditions
(CCCODEX).
CCCODEX was generated using Clinical Classification Software (formerly
known as Clinical Classifications for Health Care Policy Research
(CCHPR)), (Elixhauser,
et al., 2000), which aggregates conditions and V-codes into 260 mutually
exclusive categories, most of which are clinically homogeneous. Appendix
3 lists
the ICD-9-CM codes that have been aggregated for each clinical classification
category. Note that the reported ICD-9-CM code values were mapped
to the
appropriate clinical classification category prior to being collapsed
to 3-digit ICD-9-CM codes. A small number (less than 1 percent) of
clinical classification
codes have been edited for confidentiality purposes. Table 3 in Appendix
2 provides weighted and unweighted frequencies for CCCODEX. Labels
for all values
of the variable CCCODEX, as shown in Table 3, are provided in the
SAS programming statements included in this release (see the H69SU.TXT
file).
Return to Table of Contents
2.6.3 Utilization Variables (OBNUM – RXNUM)
The variables OBNUM, OPNUM, HHNUM, IPNUM, ERNUM, and RXNUM
indicate the total number of 2002 events that can be linked to each condition
record on the current file, i.e., office-based, outpatient, home health,
inpatient hospital stays, emergency room visits, and prescribed medicines,
respectively.
These counts of events were derived from Expenditure Event
Public Use Files (HC-067G, HC-067F, HC-067H, HC-067D, HC-067E, and HC-067A)
respectively. Events associated with conditions include all utilization that
occurred between January 1, 2002 and December 31, 2002.
Because persons can be seen for more than one condition
per visit, these frequencies will not match the person- or event-level
utilization counts. For example, if a person had one inpatient hospital stay and
was treated for a fractured hip and a fractured shoulder and a concussion, each
of these conditions has a unique record in this file and IPNUM=1 for each
record. By summing IPNUM for these records, the total inpatient hospital stays
would be three when actually there was only one inpatient hospital stay for that
person and three conditions were treated. These variables are useful for
determining the number of inpatient hospital stays for head injuries, hip
fractures, etc.
Return to Table of Contents
3.0 Sample Weight (PERWT02F)
3.1 Overview
There is a single full year person-level weight (PERWT02F)
assigned to each record for each key, in-scope person who responded to MEPS for
the full period of time that he or she was in-scope during 2002. A key person
either was a member of an NHIS household at the time of the NHIS interview, or
became a member of a family associated with such a household after being
out-of-scope at the time of the NHIS (examples of the latter situation include
newborns and persons returning from military service, an institution, or living
outside the United States). A person is in-scope whenever he or she is a member
of the civilian noninstitutionalized portion of the U.S. population.
Return to Table of Contents
3.2 Details on Person Weight Construction
The person-level weight PERWT02F was developed in several
stages. Person-level weights for Panels 6 and 7 were created separately. The
weighting process for each panel included an adjustment for nonresponse over
time and calibration to independent population figures. The calibration was
initially accomplished separately for each panel by raking the corresponding
sample weights to Current Population Survey (CPS) population estimates based on
five variables. The five variables used in the establishment of the initial
person-level control figures were: census region (Northeast, Midwest, South,
West); MSA status (MSA, non-MSA); race/ethnicity (Hispanic, black but
non-Hispanic, Asian but non-Hispanic and other); sex; and age. A 2002 composite
weight was then formed by multiplying each weight from Panel 6 by the factor .55
and each weight from Panel 7 by the factor .45. The choice of factors reflected
the relative sample sizes of the two panels, helping to limit the variance of
estimates obtained from pooling the two samples. The composite weight was again
raked to the same set of CPS-based control totals. When poverty status
information derived from income variables became available, a final raking was
undertaken on the previously established weight variable. Control totals were
established using poverty status (below poverty, from 100 to 125 percent of
poverty, from 125 to 200 percent of poverty, from 200 to 400 percent of poverty,
at least 400 percent of poverty) as well as the original five variables used in
the previous calibrations.
Return to Table of Contents
3.2.1 MEPS Panel 6 Weight
The person-level weight for MEPS Panel 6 was developed
using the 2001 full year weight for an individual as a "base" weight for survey
participants present in 2001. For key, in-scope respondents who joined an RU
some time in 2002 after being out-of-scope in 2001, the 2001 family weight
associated with the family the person joined served as a "base" weight. The
weighting process included an adjustment for nonresponse over Rounds 4 and 5 as
well as raking to population control figures for December 2002. These control
figures were derived by scaling back the population totals obtained from the
March 2002 CPS to reflect the December 2002 CPS estimated population
distribution across age and sex categories as of December 2002. Variables used
in the establishment of person-level control figures included: census region
(Northeast, Midwest, South, West); MSA status (MSA, non-MSA); race/ethnicity
(Hispanic, black but non-Hispanic, Asian but non-Hispanic, and other); sex; and
age. Overall, the weighted population estimate for the civilian
noninstitutionalized population on December 31, 2002 is 284,568,843. Key,
responding persons not in-scope on December 31, 2002 but in-scope earlier in the
year retained, as their final Panel 6 weight, the weight after the nonresponse
adjustment.
Return to Table of Contents
3.2.2 MEPS Panel 7 Weight
The person-level weight for MEPS Panel 7 was developed
using the MEPS Round 1 person-level weight as a "base" weight. For key, in-scope
respondents who joined an RU after Round 1, the Round 1 family weight served as
a "base" weight. The weighting process included an adjustment for nonresponse
over Round 2 and the 2002 portion of Round 3 as well as raking to the same
population control figures for December 2002 used for the MEPS Panel 6 weights.
The same five variables employed for Panel 6 raking (census region, MSA status,
race/ethnicity, sex, and age) were used for Panel 7 raking. Similarly, for Panel
7, key, responding persons not in-scope on December 31, 2002 but in-scope
earlier in the year retained, as their final Panel 7 weight, the weight after
the nonresponse adjustment.
Note that the MEPS Round 1 weights (for both panels with
one exception as noted below) incorporated the following components: the
original household probability of selection for the NHIS; ratio-adjustment to
NHIS-based national population estimates at the household (occupied dwelling
unit) level; adjustment for nonresponse at the dwelling unit level for Round 1;
and raking to figures at the family and person level obtained from the March
2002 CPS data base.
Return to Table of Contents
3.2.3 The Final Weight for 2002
Variables used in the establishment of person-level
control figures included: poverty status (below poverty, from 100 to 125 percent
of poverty, from 125 to 200 percent of poverty, from 200 to 400 percent of
poverty, at least 400 percent of poverty); census region (Northeast, Midwest,
South, West); MSA status (MSA, non-MSA); race/ethnicity (Hispanic, black but
non-Hispanic, Asian but non-Hispanic, and other); sex; and age. Overall, the
weighted population estimate for the civilian noninstitutionalized population
for December 31, 2002 is 284,568,843 (PERWT02F>0 and INSC1231=1). The weights of
some persons out-of-scope on December 31, 2002 were also calibrated, this time
using poststratification. Specifically, the weights of persons out-of-scope on
December 31, 2002 who were in-scope some time during the year and also entered a
nursing home during the year were poststratified to a corresponding control
total obtained from the 1996 MEPS Nursing Home Component. The weights of persons
who died while in-scope during 2002 were poststratified to corresponding
estimates derived using data obtained from the Medicare Current Beneficiary
Survey (MCBS) and Vital Statistics information provided by the National Center
for Health Statistics (NCHS). Separate control totals were developed for the "65
and older" and "under 65" civilian noninstitutionalized populations. The sum of
the person-level weights across all persons assigned a positive person level
weight is 288,181,763.
Return to Table of Contents
3.2.4 Coverage
The target population for MEPS in this file is the 2002
U.S. civilian noninstitutionalized population. However, the MEPS sampled
households are a subsample of the NHIS households interviewed in 2000 (Panel 6)
and 2001 (Panel 7). New households created after the NHIS interviews for the
respective Panels and consisting exclusively of persons who entered the target
population after 2000 (Panel 6) or after 2001 (Panel 7) are not covered by MEPS.
Neither are previously out-of-scope persons who join an existing household but
are unrelated to the current household residents. Persons not covered by a given
MEPS panel thus include some members of the following groups: immigrants;
persons leaving the military; U.S. citizens returning from residence in another
country; and persons leaving institutions. The set of uncovered persons
constitutes only a small segment of the MEPS target population.
Return to Table of Contents
4.0 Merging MEPS Data Files
Data from the current file can be used alone or in
conjunction with other files. Merging characteristics of interest from
person-level files expands the scope of potential estimates. See HC-067I for
instructions on merging the condition file to the Medical Event Files.
Person-level characteristics can be merged to this Conditions File using the
following procedure:
- Sort the person-level file by person identifier,
DUPERSID. Keep only DUPERSID and the variables to be merged onto the
Conditions File.
- Sort the conditions file by person identifier,
DUPERSID.
- Merge both files by DUPERSID, and output all records
in the conditions file.
- If PERS contains the person-level variables, and COND
is the conditions file, the following code can be used to add person-level
variables to the person’s conditions in condition-level file.
PROC SORT DATA=PERS(KEEP=DUPERSID AGE SEX EDUCLEVL)
OUT=PERSX; BY DUPERSID;
RUN;
PROC SORT DATA=COND; BY DUPERSID;
RUN;
DATA COND;
MERGE COND (IN=A) PERSX(IN=B); BY DUPERSID;
IF A;
RUN;
Return to Table of Contents
References
Cohen, S. B. (1997). A Sample Design of the 1996 Medical
Expenditure Panel Survey Household Component, Rockville (MD): Agency for
Healthcare Research and Quality; 1997. MEPS Methodology Report, No. 2.
AHCPR Pub. No. 97-0027.
Cohen, J. W. (1997). A Design and Methods of the Medical
Expenditure Panel Survey Household Component. Rockville (MD): Agency for
Healthcare Research and Quality; 1997. MEPS Methodology Report, No.1.
AHCPR Pub. No. 97-0026.
Cohen, S. B. (1996). The Redesign of the Medical
Expenditure Panel Survey: A Component of the DHHS Survey Integration Plan.
Proceedings of the COPAFS Seminar on Statistical Methodology in the Public
Service.
Cox, B. and Iachan, R. (1987). A Comparison of Household
and Provider Reports of Medical Conditions. Journal of the American
Statistical Association 82(400):1013-18.
Edwards, W. S., Winn, D. M., Kurlantzick, V., et al.
Evaluation of National Health Interview Survey Diagnostic Reporting. National
Center for Health Statistics, Vital Health 2(120). 1994.
Elixhauser, A., Steiner, C. A., Whittington,, C. A., and
McCarthy, E. Clinical Classifications for health policy research: Hospital
inpatient statistics, 1995. Healthcare Cost and Utilization project, HCUP-3
research Note. Rockville, MD: Agency for Healthcare Research and Quality;
2000. AHCPR Pub. No. 98-0049.
Health Care Financing Administration (1980).
International Classification of Diseases, 9th Revision, Clinical
Modification (ICD-CM). Vol. 1. (DHHS Pub. No (PHS) 80-1260). DHHS: U.S. Public
Health Services.
Johnson, Ayah E., and Sanchez, Maria Elena. (1993),
"Household and Medical Reports on Medical Conditions: National Medical
Expenditure Survey." Journal of Economic and Social Measurement,
19, 199-223.
Return to Table of Contents
Appendix 1 Variable to Source Crosswalk
UNIQUE IDENTIFIER VARIABLES
VARIABLE |
LABEL |
SOURCE[1] |
| DUID |
Dwelling Unit ID |
Assigned In Sampling |
| PID |
Person Number |
Assigned In Sampling |
| DUPERSID |
Person ID (DUID + PID) |
Assigned In Sampling |
| CONDN |
Condition Number |
CAPI Derived |
| CONDIDX |
Condition ID |
CAPI Derived |
| PANEL02 |
Panel Number |
Constructed |
| CONDRN |
Condition Round Number |
CAPI Derived |
[1] Read the
Summary of questionnaire sections for
information on the
MEPS HC questionnaire sections (e.g., CN, DD) shown in the Source column.
Return to Table of Contents
MEDICAL CONDITION VARIABLES
VARIABLE |
LABEL |
SOURCE[1] |
| PRIOLIST |
Is Condition On Priority List |
CN02 |
| CONDBEGD |
Date Condition Started -- Day |
CN05 |
| CONDBEGM |
Date Condition Started -- Month |
CN05 |
| CONDBEGY |
Date Condition Started --Year |
CN05 |
| SEEDREV1 |
RD1: Ever Seen Dr For Cond |
CN03, CN17 |
| SEEDREV2 |
RD2: Ever Seen Dr For Cond |
CN03, CN17 |
| SEEDREV3 |
RD3: Ever Seen Dr For Cond |
CN03, CN17 |
| SEEDREV4 |
RD4: Ever Seen Dr For Cond |
CN03, CN17 |
| SEEDREV5 |
RD5: Ever Seen Dr For Cond |
CN03, CN17 |
| LSTSAW1 |
RD1: When Was Last Time Dr Was Seen |
CN04 |
| STILTR1 |
RD1: Is Pers Still Treated For Cond |
CN11, CN18 |
| STILTR2 |
RD2: Is Pers Still Treated For Cond |
CN11, CN18 |
| STILTR3 |
RD3: Is Pers Still Treated For Cond |
CN11, CN18 |
| STILTR4 |
RD4: Is Pers Still Treated For Cond |
CN11, CN18 |
| STILTR5 |
RD5: Is Pers Still Treated For Cond |
CN11, CN18 |
| OVRALL1 |
RD1: How Cond Affect Overall Health |
CN13, CN19 |
| OVRALL2 |
RD2: How Cond Affect Overall Health |
CN13, CN19 |
| OVRALL3 |
RD3: How Cond Affect Overall Health |
CN13, CN19 |
| OVRALL4 |
RD4: How Cond Affect Overall Health |
CN13, CN19 |
| OVRALL5 |
RD5: How Cond Affect Overall Health |
CN13, CN19 |
| WHOTYP1 |
RD1: Who Reported Condition Affect |
CN13OV, CN19OV |
| WHOTYP2 |
RD2: Who Reported Condition Affect |
CN13OV, CN19OV |
| WHOTYP3 |
RD3: Who Reported Condition Affect |
CN13OV, CN19OV |
| WHOTYP4 |
RD4: Who Reported Condition Affect |
CN13OV, CN19OV |
| WHOTYP5 |
RD5: Who Reported Condition Affect |
CN13OV, CN19OV |
| FURTCA1 |
RD1: Further Treatment Recommended |
CN14 |
| FURTCA2 |
RD2: Further Treatment Recommended |
CN14 |
| FURTCA3 |
RD3: Further Treatment Recommended |
CN14 |
| FURTCA4 |
RD4: Further Treatment Recommended |
CN14 |
| FURTCA5 |
RD5: Further Treatment Recommended |
CN14 |
| FOLOCA1 |
RD1: Rcv FollowUp Care For Condition |
CN15 |
| FOLOCA2 |
RD2: Rcv FollowUp Care For Condition |
CN15 |
| FOLOCA3 |
RD3: Rcv FollowUp Care For Condition |
CN15 |
| FOLOCA4 |
RD4: Rcv FollowUp Care For Condition |
CN15 |
| FOLOCA5 |
RD5: Rcv FollowUp Care For Condition |
CN15 |
| SEEDREF1 |
RD1: Saw Dr In Reference Period |
CN03, CN17 |
| SEEDREF2 |
RD2: Saw Dr In Reference Period |
CN03, CN17 |
| SEEDREF3 |
RD3: Saw Dr In Reference Period |
CN03, CN17 |
| SEEDREF4 |
RD4: Saw Dr In Reference Period |
CN03, CN17 |
| SEEDREF5 |
RD5: Saw Dr In Reference Period |
CN03, CN17 |
| CRND1 |
Has Condition Information In Round |
Constructed |
| CRND2 |
Has Condition Information In Round |
Constructed |
| CRND3 |
Has Condition Information In Round |
Constructed |
| CRND4 |
Has Condition Information In Round |
Constructed |
| CRND5 |
Has Condition Information In Round |
Constructed |
| PRIORFLG |
Location Of Rnd Specific Priority Info |
Constructed |
| INJURY |
Was Condition Due To Accident/Injury |
CN02 |
| ACCDENTD |
Date Of Accident -- Day |
CN06 |
| ACCDENTM |
Date Of Accident -- Month |
CN06 |
| ACCDENTY |
Date Of Accident -- Year |
CN06 |
| ACCDNWRK |
Did Accident Occur At Work |
CN07 |
| ACDNTLOC |
Where Did Accident Happen |
CN08 |
| INOUTHH |
Was Accident Inside/Outside The House |
CN09 |
| VEHICLE |
Was A Motor Vehicle Involved |
CN10 |
| GUN |
Was A Gun Involved |
CN10 |
| WEAPON |
Was Some Other Weapon Involved |
CN10 |
| POISON |
Was Poison/Poisonous Substance Involved |
CN10 |
| FIREBURN |
Was Fire/Burning Involved |
CN10 |
| DROWN |
Was Drowning/Near-Drowning Involved |
CN10 |
| SPORTS |
Was It A Sports Injury |
CN10 |
| FALL |
Was It A Fall |
CN10 |
| ACDNTOTH |
Was Something Else Involved |
CN10 |
| RECOVER |
Fully Recovered From Condition |
CN12 |
| INJURFLG |
Location Of Rnd Specific Injury Info |
Constructed |
| MISSWORK |
Flag Associated With Missed Work Days |
DD03 |
| MISSSCHL |
Flag Associated With Missed School Days |
DD06 |
| INBEDFLG |
Flag Associated With Bed Days |
DD09 |
| ICD9CODX |
ICD-9-CM Code For Condition - Edited |
CE05, HS04, ER04,
OP09, MV09, HH05,
PM09 (Edited) |
| ICD9PROX |
ICD-9-CM Code For Procedure - Edited |
CE05, HS04, ER04,
OP09, MV09, HH05,
PM09 (Edited) |
| CCCODEX |
Clinical Classification Code - Edited |
Constructed/Edited |
Return to Table of Contents
UTILIZATION VARIABLES
VARIABLE |
LABEL |
SOURCE[1] |
| HHNUM |
# Home Health Events Assoc. w/ Condition |
Constructed |
| IPNUM |
# Inpatient Events Assoc. w/ Condition |
Constructed |
| OPNUM |
# Outpatient Events Assoc. w/ Condition |
Constructed |
| OBNUM |
# Office-Based Events Assoc. w/ Condition |
Constructed |
| ERNUM |
# ER Events Assoc. w/ Condition |
Constructed |
| RXNUM |
# Prescribed Medicines Assoc. w/ Cond. |
Constructed |
Return to Table of Contents
WEIGHTS AND VARIANCE ESTIMATION VARIABLES
VARIABLE |
LABEL |
SOURCE[1] |
| PERWT02F |
Expenditure File Person Weight, 2002 |
Constructed |
| VARSTR |
Variance Estimation Stratum, 2002 |
Constructed |
| VARPSU |
Variance Estimation PSU, 2002 |
Constructed |
Return to Table of Contents
Appendix 2 Condition, Procedure
and Clinical Classification Code Frequencies (link to separate file)
Return to Table of Contents
Appendix 3 Clinical Classification Code to ICD-9-CM Code Crosswalk (link to CCS/ICD9CM crosswalk)
Return to Table of Contents
Appendix 4 List of Priority Conditions
A. LONG-TERM, LIFE THREATENING CONDITIONS:
|
Cancer (of any body part)
cancer
tumor
malignancy
malignant tumor
carcinoma
sarcoma
lymphoma
Hodgkin’s disease
leukemia
melanoma
metastasis
neuroma
adenoma
Diabetes
diabetes
diabetes mellitus
high blood sugar
juvenile diabetes (Type I diabetes)
adult-onset diabetes (Type II diabetes)
diabetic neuropathy
Emphysema
emphysema
chronic obstructive pulmonary disease
(COPD)
chronic bronchitis (MUST use the word
"chronic", only for adults)
chronic obstructive bronchitis (MUST
use the word "chronic", only for
adults)
smoker’s cough |
High Cholesterol
high cholesterol
high or elevated triglycerides
hyperlipidemia
hypercholesterolemia
HIV/AIDS
HIV
AIDS
Hypertension
hypertension
high blood pressure
Ischemic Heart Disease
ischemic heart disease (MUST use
the word "ischemic")
angina
angina pectoris
coronary artery disease
blocked, obstructed, or occluded
coronary arteries
arteriosclerosis
myocardial infarction
heart attack
Stroke
stroke
cerebral hemorrhage
cerebral aneurysm
transient ischemic accident
transient ischemic attack
apoplexy
carotid artery blockage
arterial thrombosis in brain
blood clot in brain |
Return to Table of Contents
B. CHRONIC, MANAGEABLE CONDITIONS:
|
Arthritis
anything with the word "arthritis"
rheumatoid arthritis
degenerative arthritis
osteoarthritis
bursitis
rheumatism
Asthma
anything with the word "asthma" or
"asthmatic"
Gall Bladder Disease
gall bladder disease, trouble,
attacks, infection, or problems
gallstones
Stomach Ulcers
stomach ulcer
duodenal ulcer
peptic ulcer
bleeding ulcer
ulcerated stomach
perforated ulcer |
Back Problems of Any Kind
back problems or pain of any kind
(lower or upper back)
sore, hurt, injured, or stiff back
backache
anything with the words "vertebra",
"vertebrae", "lumbar", "spine", or
"spinal"
sprained back
muscle spasms
back spasms
bad back
lumbago
sciatica or sciatic nerve problems
disc problems: herniated, ruptured,
slipped, compressed, extruded,
dislocated, deteriorated, or misaligned
discs |
Return to Table of Contents
C. MENTAL HEALTH ISSUES:
Alzheimer’s Disease and Other Dementias
anything with the words "Alzheimer’s" or "dementia"
organic brain syndrome
Depression and Anxiety Disorders
depression (including severe, chronic, or major depression)
dysthymia
dysthymic disorder
bipolar disorder
manic depression or manic depressive illness
anxiety attacks
panic attacks
anxiety
nerves
nervous condition
nervous breakdown
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