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MEPS HC-217
Panel 23 Longitudinal Data File

September 2021

Agency for Healthcare Research and Quality
Center for Financing, Access, and Cost Trends
5600 Fishers Lane
Rockville, MD 20857
(301) 427-1406


Table of Contents


A. Data Use Agreement
B. Background
1.0 Household Component
2.0 Medical Provider Component
3.0 Survey Management and Data Collection
C. Technical and Programming Information
1.0 General Information
2.0 Data File Information
2.1 Variables
2.1.1 Variables from Annual Full-year Consolidated Files
2.1.2 Constructed Variables for Selection of Group
2.1.3 Estimation Variables


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

1.0 Household Component

The Medical Expenditure Panel Survey (MEPS) provides nationally representative estimates of health care use, expenditures, sources of payment, and health insurance coverage for the U.S. civilian noninstitutionalized population. The MEPS Household Component (HC) also provides estimates of respondents’ health status, demographic and socio-economic characteristics, employment, access to care, and satisfaction with healthcare. Estimates can be produced for individuals, families, and selected population subgroups. The panel design of the survey, which includes 5 Rounds of interviews covering 2 full calendar years, provides data for examining person level changes in selected variables such as expenditures, health insurance coverage, and health status. Using computer assisted personal interviewing (CAPI) technology, information about each household member is collected, and the survey builds on this information from interview to interview. All data for a sampled household are reported by a single household respondent.


The MEPS-HC was initiated in 1996. Each year a new panel of sample households is selected. Because the data collected are comparable to those from earlier medical expenditure surveys conducted in 1977 and 1987, it is possible to analyze long-term trends. Each annual MEPS HC sample size is about 15,000 households. Data can be analyzed at either the person or event level. Data must be weighted to produce national estimates.


The set of households selected for each panel of the MEPS HC is a subsample of households participating in the previous year’s National Health Interview Survey (NHIS) conducted by the National Center for Health Statistics. The NHIS sampling frame provides a nationally representative sample of the U.S. civilian noninstitutionalized population. In 2006, the NHIS implemented a new sample design, which included Asian persons in addition to households with Black and Hispanic persons in the oversampling of minority populations. NHIS introduced a new sample design in 2016 that discontinued oversampling of these minority groups. The linkage of the MEPS to the previous year’s NHIS provides additional data for longitudinal analytic purposes.

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2.0 Medical Provider Component

Upon completion of the household CAPI interview and obtaining permission from the household survey respondents, a sample of medical providers are contacted by telephone to obtain information that household respondents can not accurately provide. This part of the MEPS is called the Medical Provider Component (MPC) and information is collected on dates of visits, diagnosis and procedure codes, charges and payments. The Pharmacy Component (PC), a subcomponent of the MPC, does not collect charges or diagnosis and procedure codes but does collect drug detail information, including National Drug Code (NDC) and medicine name, as well as amounts of payment. The MPC is not designed to yield national estimates. It is primarily used as an imputation source to supplement/replace household reported expenditure information.

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3.0 Survey Management and Data Collection

MEPS HC and MPC data are collected under the authority of the Public Health Service Act. Data are collected under contract with Westat, Inc. (MEPS HC) and Research Triangle Institute (MEPS MPC). Data sets and summary statistics are edited and published in accordance with the confidentiality provisions of the Public Health Service Act and the Privacy Act. The National Center for Health Statistics (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, micro data files, and tables via the MEPS website.
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, 5600 Fishers Lane, Rockville, MD 20857 (301-427-1406).

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C. Technical and Programming Information

1.0 General Information

This documentation describes the Panel 23 longitudinal data file from the Medical Expenditure Panel Survey Household Component (MEPS-HC). Released as an ASCII file (with related SAS, STATA, SPSS, and R programming statements and data user information), a SAS data set, a SAS transport dataset, a STATA dataset, and an Excel file, this public use file provides information collected on a nationally representative sample of the civilian noninstitutionalized population of the United States for the two-year period 2018-2019. The file contains 2,750 variables and has a logical record length of 7,911 with an additional 2-byte carriage return/line feed at the end of each record.


This file consists of MEPS survey data obtained in Rounds 1-5 of MEPS Panel 23 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 2018 and 2019 Full-Year Consolidated Files (HC-209 and HC-216, respectively).


The following documentation offers a brief overview of the contents and structure of the files and programming information. A codebook of all the variables included in the Panel 23 data file is provided in a separate file (H217CB.PDF). A database of all MEPS products released to date and a variable locator indicating the major MEPS data items on public use files that have been released to date can be found on the MEPS website.

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2.0 Data File Information

This public use file contains records for 14,067 persons in Panel 23 who were respondents for the period they were in-scope for the survey (i.e., a member of the civilian non-institutionalized population) during the two-year period. Only persons with positive person-level weights (PERWT18F or PERWT19F are included in the longitudinal PUF data. Data are available for all five rounds for 92.7% of the cases (13,044). The remaining 7.3% (1,023 persons) do not have data for one or more rounds but were in-scope for all rounds they participated in the survey. These persons are those who were born, died, were in the military or an institution, or left the country during the two-year period. In contrast, persons in the panel who participated in the survey for only part of the period they were in-scope are not included in this file. To compensate for this attrition, adjustments were made in the construction of the panel weight variable included in this file (LONGWT). The codebook provides both weighted and unweighted frequencies for each variable on the data file. The LONGWT variable should be used to produce national estimates for the two-year period.


Each MEPS panel can be linked back to the previous year’s National Health Interview Survey public use data files. For information on obtaining MEPS/NHIS link files please see the MEPS website.

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2.1 Variables

2.1.1 Variables from Annual Full-Year Consolidated Files

Most variables on this file were obtained from the MEPS 2018 and 2019 Full-Year Consolidated Files (HC-209 and HC-216, respectively). However, names for time dependent variables from these files were modified in order to: 1) eliminate duplicate variable names for data reflecting different time periods during the panel, and 2) standardize variable names to facilitate pooling of multiple MEPS panels for analysis1. Generally, annual variables with a suffix of "18" and "19" are renamed with a suffix of "Y1" and "Y2", respectively. Variables with a suffix of "31", "42", and "53" are renamed with a suffix denoting the round the data was collected (i.e., "1" , "2" or "3" for variables originating from Rounds 1-3 on the 2018 full-year file and "3", "4", or "5" for variables originating from Rounds 3-5 on the 2019 full-year file)2. It is necessary to use this crosswalk in conjunction with documentation for the 2018 and 2019 full-year consolidated files to obtain a full description of variables on this file. Table 1 below provides the crosswalk summarizing the scheme used for renaming variables from the annual files.



1 A variable named PANEL is also included to facilitate pooling across panels. This variable is simply the panel number and is therefore constant across all records within a longitudinal file. The ten-character variable DUPERSID uniquely identifies each person represented on the file and is the combination of the variables DUID (PANEL + Dwelling Unit ID) and PID (Person Number).
2 While round 3 values were obtained for most observations from the 2019 Full Year Consolidated File, they were obtained from the 2018 Full Year Consolidated File for sample persons where YEARIND=2 (i.e., in 2018 only).
Table 1. Crosswalk of Variable Names between the Full-Year Consolidated Files and the Longitudinal File

Type of Variable

Full-Year Consolidated File Variable Name Suffix

Longitudinal File Variable Name Suffix 

Specific cases or examples

 

Constant (i.e., not round or year specific)

 

No suffixes

 

No suffixes

All variables:

BORNUSA=BORNUSA

DOBMM=DOBMM

DOBYY=DOBYY 

DUID=DUID

PID=PID

DUPERSID=DUPERSID

EDUCYR=EDUCYR

HIDEG=HIDEG

HISPANX=HISPANX

HISPNCAT=HISPNCAT 

HWELLSPK=HWELLSPK 

INTVLANG=INTVLANG 

OTHLGSPK=OTHLGSPK

PANEL=PANEL

PID=PID

RACEAX=RACEAX

RACEBX=RACEBX

RACEWX=RACEWX

RACEV1X=RACEV1X

RACEV2X=RACEV2X

RACETHX=RACETHX

SEX=SEX

VARPSU=VARPSU

VARSTR=VARSTR

WHTLGSPK=WHTLGSPK

YRSINUS=YRSINUS 

 

Annual, family related variables

 

YR

 

Y1 or YR1

 

 

 

Y2 or YR2

All variables:

FAMIDYR=FAMIDYR1 (2018 file)

FAMRFPYR=FAMRFPY1 (2018 file)

FAMSZEYR=FAMSZYR1 (2018 file)

 

FAMIDYR=FAMIDYR2 (2019 file)

FAMRFPYR=FAMRFPY2 (2019 file)

FAMSZEYR=FAMSZYR2 (2019 file)

 

Annual, CPS family identifiers

 

No suffix

 

Y1  

 

Y2  

All variables:

CPSFAMID= CPSFAMY1 (2018 file)

 

CPSFAMID= CPSFAMY2 (2019 file) 

 

Annual, health insurance eligibility units

 

No suffix

 

Y1  

 

Y2  

All variables:

HIEUIDX=HIEUIDY1 (2018 file)

 

HIEUIDX=HIEUIDY2 (2019 file) 

 

Annual, inscope variables

 

No suffixes

 

YR1

 

YR2

All variables:

INSCOPE=INSCPYR1 (2018 file)

 

INSCOPE=INSCPYR2 (2019 file)

 

12/31 status variables

 

1231 in 2018 file

 

 

 

 

 

1231 in 2019 file

 

Y1  

 

 

 

 

 

Y2  

All variables:

FAMS1231=FAMSY1 (2017 file)

FCRP1231=FCRPY1 (2017 file)

FCSZ1231= FCSZY1 (2017 file)

FMRS1231= FMRSY1 (2017 file)

INSC1231=INSCY1 (2017 file)

 

FAMS1231=FAMSY2 (2018 file)

FCRP1231=FCRPY2 (2018 file)

FCSZ1231= FCSZY2 (2018 file)

FMRS1231= FMRSY2 (2018 file)

INSC1231=INSCY2 (2018 file)

 

Annual

 

18, 18X, 18F, or 18C

 

 

19, 19X, 19F, or 19C

 

Y1, Y1X, Y1F, or Y1C

 

 

Y2, Y2X, Y2F, or Y2C

Examples:

TOTEXP18=TOTEXPY1

AGE18X=AGEY1X

 

TOTEXP19=TOTEXPY2

AGE19X=AGEY2X

 

Variables for health insurance prior to January 1, 2018

(data collected in round 1 only) 

 

No suffixes

 

No suffixes

All variables:

PREVCOVR=PREVCOVR

MORECOVR=MORECOVR

 

Annual

 

No suffixes3

 

Y1  

 

 

 

 

 

 

Y2  

 

Examples:

KEYNESS=KEYNESY1 (2018 file)

SAQELIG=SAQELIY1 (2018 file)

EVRWRK=EVRWRKY1 (2018 file)

EVRETIRE=EVRETIY1 (2018 file)

AGELAST=AGELSTY1 (2018 file)

DIABDX_M18=DIABDXY1_M18 (2018 file)

 

KEYNESS=KEYNESY2 (2019 file)

SAQELIG=SAQELIY2 (2019 file)

EVRWRK=EVRWRKY2 (2019 file)

EVRETIRE=EVRETIY2 (2019 file)

AGELAST=AGELSTY2 (2019 file)

DIABDX_M18=DIABDXY2_M18 (2019 file)

 

Monthly

 

2-character month + 18

2-character month + 19

 

2-character month + Y1

2-character month + Y2

Example:

PRIJA18=PRIJAY1 (2018 file)

PRIJA19=PRIJAY2 (2019 file)

 

Round Specific

 

31, 31X, or 31H in 2018 file 

42, 42X, or 42H in 2018 file 

53, 53X, or 53H in 2018 file 

31_M18 in 2018 file

42_M18 in 2018 file

 

31, 31X, or 31H in 2019 file

42, 42X, or 42H in 2019 file 

53, 53X, or 53H in 2019 file 

31_M18 in 2019 file

42_M18 in 2019 file

 

1, 1X, or 1H for 2018

 

2, 2X, or 2H for 2018

 

3, 3X, or 3H for 2018

 

1_M18 for 2018

2_M18 for 2018

 

3, 3X, 3H for 2019

 

4, 4X, 4H for 2019

 

5, 5X, 5H for 2019

 

3_M18 for 2019

4_M18 for 2019

Example:

RTHLTH31=RTHLTH1 (2018 file)

 

RTHLTH42=RTHLTH2 (2018 file)

 

RTHLTH53=RTHLTH3 (2018 file if YEARIND=2)

JTPAIN31_M18=JTPAIN1_M18

PROVTY42_M18=PROVTY2_M18

 

RTHLTH31= RTHLTH3 (2019 file if YEARIND=1 or 3)

RTHLTH42=RTHLTH4 (2019 file)

 

RTHLTH53=RTHLTH5 (2019 file)

 

JTPAIN31_M18=JTPAIN3_M18

PROVTY42_M18=PROVTY4_M18

 

Diabetes preventive care

 

1753, 1853, and 1953 in 2018 file

 

 

 

1853, 1953, and 2053 in 2019 file

 

Y0R3 for 2017

Y1R3 for 2018

Y2R3 for 2019

 

 

Y1R5 for 2018

Y2R5 for 2019

Y3R5 for 2020

Example:

DSEB1753=DSEBY0R3 (2018 file)

DSEY1753=DSEYY0R3 (2018 file)

DSEY1853=DSEYY1R3 (2018 file)

DSEY1953=DSEYY2R3 (2018 file)

 

DSEB1853=DSEBY1R5 (2019 file)

DSEY1853=DSEYY1R5 (2019 file)

DSEY1953=DSEYY2R5 (2019 file)

DSEY2053=DSEYY3R5 (2019 file)

 

Job Change

 

3142 or 4253

 

12 for 2018

23 for 2018

 

 

 

34 for 2019

45 for 2019

All cases:

CHGJ3142=CHGJ12(2018 file)

CHGJ4253=CHGJ23(2018 file)

YCHJ3142=YCHJ12(2018 file)

YCHJ4253=YCHJ23(2018 file)

 

CHGJ3142=CHGJ34 (2019 file)

CHGJ4253=CHGJ45 (2019 file)

YCHJ3142=YCHJ34 (2019 file)

YCHJ4253=YCHJ45 (2019 file)

 

Cancer/

Cancer in remission4

 

No suffixes5

 

Y1 for 2018

 

Y2 for 2019

Example:

CALUNG=CALUNGY1 (2018 file)

 

CALUNG=CALUNGY2 (2019 file)

 

Age of Diagnosis

 

No suffixes5

 

Y1 for 2018

 

 

Y2 for 2019

Example:

CHDAGED=CHDAGY1 (2018 file) 

CHOLAGED=CHOLAGY1(2018 file)

 

CHDAGED=CHDAGY2 (2019 file)

CHOLAGED=CHOLAGY2(2019 file)



[3] To maintain a previously-implemented 8-character naming convention, some variable names had the last character or two dropped in the renaming process. A few variables have names longer than 8 characters because they were modified in 2018 and tagged with an '_M18' suffix. These variables were altered in the same fashion they would have been without the _M18 suffix, and the _M18 suffix was retained.

[4] Starting in 2010, variables were added to indicate whether each reported cancer was in remission.

[5]To maintain a previously implemented 8-character naming convention, some variable names had the last character or two dropped in the renaming process.

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2.1.2 Constructed Variables for Selection of Group

The following eight variables were constructed and included on the file to facilitate the selection of appropriate cases for various analyses. Table 2 below contains descriptive statistics for these variables.

YEARIND 1=both years, 2=in 2018 only, and 3=in 2019 only
ALL5RDS In scope and data collected in all 5 rounds (0=no, 1=yes)
DIED Died during the two-year survey period (0=no, 1=yes)
INST Institutionalized for some time during the two-year survey period (0=no, 1=yes)
MILITARY Active duty military for some time during the two-year survey period (0=no, 1=yes)
ENTRSRVY Entered survey after beginning of panel (mainly births; also includes persons who had no initial chance of selection who moved into a MEPS sample household) (0=no, 1=yes)
LEFTUS Moved out of the country after beginning of panel (0=no, 1=yes)
OTHER Not identified in any of the above analytic groups (0=no, 1=yes)

Table 2. Frequencies and Percentage for Constructed Variables


Variable

Number of Records 

Percentage of Records (N=14,067)

YEARIND=1 (i.e., person in both years)

13,766

98.0

ALL5RDS=1 (yes)

13,044

92.7

DIED=1 (yes)

216

1.5

INST=1 (yes)

51

0.4

MILITARY=1 (yes)

28

0.2

ENTRSRVY=1 (yes)

651

4.6

LEFTUS=1 (yes)

28

0.2

OTHER=1 (yes)

62

0.4


Following are examples of situations where these variables would be useful in selecting records for analysis:

  • Analysts interested in working only with persons who were in-scope and had data for all five rounds of the panel should subset to cases where ALL5RDS=1.
  • If a researcher wanted to include persons who were in-scope and had data for all five rounds of the panel as well as those in the survey at the beginning of the panel who subsequently died, then they would include cases where ALL5RDS=1 or (ENTRSRVY=0 and DIED=1).
  • If a researcher wanted to include persons who were in-scope and had data for all five rounds of the panel as well as those who died in the second year of the panel, then they would include cases where ALL5RDS=1 or (DIED=1 and YEARIND=1).

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2.1.3 Estimation Variables

Longitudinal Estimations for Panel 23

The file contains a weight variable (LONGWT) and variance estimation variables (VARSTR, VARPSU) that should be applied when producing national estimates for longitudinal analyses. For example, LONGWT applied to the 13,044 cases where ALL5RDS=1 produces a weighted population estimate of 305.7 million. This represents an estimate of the number of persons in the civilian noninstitutionalized population for the entire two-year period from 2018-2019. To obtain estimates of variability (such as the standard error of sample estimates or corresponding confidence intervals) for estimates based on MEPS survey data, one needs to take into account the complex sample design of MEPS by specifying the estimation variables including stratum of sample selection (VARSTR), primary sampling unit (VARPSU) and longitudinal weight (LONGWT).


This longitudinal file also contains a longitudinal SAQ weight variable (LSAQWT). This weight variable should be used to perform longitudinal analyses involving any variables from the self-administered questionnaire (SAQ) which was administered to persons age 18 and older in both rounds 2 and 4 of the survey. The variable SAQRDS24 can be used to identify which persons have SAQ data for both versus only one of the two rounds. Table 3 below provides the estimated population size (i.e., the sum of LSAQWT values) for cases with only one round of SAQ data (i.e., SAQRDS24=0) and for cases with both rounds of SAQ data (i.e., SAQRDS24=1). The estimated population size for analyses based on the 8,375 cases with SAQ data for both rounds (i.e., SAQRDS24=1) is 229.4 million.


Table 3. Number of Respondents and Estimated Population Size for SAQ Analyses


Value of
SAQRDS24

Description

Number of
Respondents
(Unweighted)

Estimated Population
Size (Weighted by
LSAQWT)

0

Persons with one round of SAQ data

5,692

21,232,935

1

Persons with both rounds of SAQ data

8,375

229,351,131

Total

All SAQ respondents

14,067

250,584,066


Pooled Estimations

When analyzing subpopulations and/or low prevalence events, it may be desirable to pool together more than one panel of MEPS-HC data to yield sample sizes large enough to generate reliable estimates. If only data from Panels 7 and beyond are being pooled, then simply use the strata and PSU variables (VARSTR, VARPSU)[6] provided on the longitudinal files for pooled estimation. However, because Panels 1-6 MEPS longitudinal weight files were released with panel-specific variance structures, it is necessary to obtain the set of appropriate variance estimation variables from the HC-036 Pooled Estimation File when pooling involves these panels.

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[6]Note that variable names for strata and PSU are VARSTR and VARPSU, respectively, in longitudinal files for panel 9 and beyond. These variables were named differently in the longitudinal files for panel 7 (VARSTRP7, VARPSUP7) and panel 8 (VARSTRP8, VARPSUP8) and need to be standardized when pooling with subsequent panels.



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