An assessment of the impact of two distinct survey design modifications on health care utilization estimates in the medical expenditure panel survey

Abstract

The Medical Expenditure Panel Survey (MEPS) is one of the core health care surveys that are a primary source for essential national healthcare utilization estimates. In 2007, the survey experienced two dominant survey design modifications: a new sample design attributable to the sample redesign of the National Health Interview Survey, and an upgrade to the Computer Assisted Personal Interview (CAPI) platform for the survey instrument, moving from a DOS to a Windows based environment. This study examines the impact of these survey design modifications on the national health care utilization estimates. Particular attention is given to assessing the level of convergence in utilization estimates based on the alternative designs as well as the alignment of model based analyses that discern which factors are associated with health care use. The paper concludes with a discussion of strategies that may yield additional improvements in the accuracy for these policy relevant survey estimates.