Appendix 2: Summary of Surveys Used in The Burden of Digestive Diseases in the United States

The Burden of Digestive Diseases in the United States

Constance E. Ruhl, M.D., Ph.D.; and Bryan Sayer, M.H.S.

National Ambulatory Medical Care Survey (NAMCS)

Sponsor

Ambulatory Care Statistics Branch
Division of Health Care Statistics
National Center for Health Statistics
Centers for Disease Control and Prevention
U.S. Department of Health and Human Services
3311 Toledo Road
Hyattsville, MD 20782
301-458-4600

Design

The National Ambulatory Medical Care Survey (NAMCS) is a continuing series of nationally representative sample surveys of office-based physicians in the United States. The survey includes all non-Federal office-based physicians who are primarily engaged in direct patient care. Anesthesiologists, pathologists, and radiologists are excluded. The design is a multistage stratified probability sample of geographically defined areas, physician practices within these areas, and patient visits within physician practices. Physicians are asked to complete a patient encounter form for a systematic sample of office visits occurring during a randomly assigned 1-week reporting period.

The study design is described in: National Center for Health Statistics, Bryant E, Shimuzu I. Sample design, sampling variance, and estimation procedures for the National Ambulatory Medical Care Survey. Hyattsville, Maryland: Public Health Service, 1988; DHHS Publication No. (PHS) 88-1382. (Vital and health statistics, Series 2, No. 108.)

Timeframe

Data were collected annually from 1974 through 1981, and in 1985; data have been collected annually since 1989. Data from 1992 through 2005 were used in this report.

Sample Size

Through 1981, the sample included 3,000 total physicians, about 1,925 responding physicians, and about 51,000 patient visits. The 1985 sample included about 5,000 total physicians, 2,900 responding physicians, and 70,000 patient visits. Beginning in 1989, the sample included 2,500 total physicians, about 1,600 responding physicians, and about 42,000 patient visits.

Content Relevant to Digestive Diseases

Demographic data, reason for visit, physician’s diagnostic and therapeutic services ordered or provided, diagnosis and disposition decision, and drugs prescribed are included. International Classification of Diseases (ICD) codes are given for the first four physician diagnoses. The reason for office visit is the principal reason given by the patient, which in the physician’s judgment is the most appropriate one. Two additional symptoms or other reasons for visit can be coded.

Strengths

The survey form is completed from provider records. Trend data are available for about 30 years. Visits can be compared with those of the National Health Interview Survey, in which the conditions are similarly defined. Since 1980, data have been collected on the number and names of specific drugs prescribed in office-based practice. The sample allows estimates for specific physician subspecialties. ICD codes are used for diagnoses.

Limitations

The sample is limited to office-based physicians, a group that has become a less inclusive source for ambulatory care. There may be more than one report per person, because the report reflects a visit rather than an individual. The sample size is small, so estimates of fewer than 200,000 are statistically unreliable. Because ambulatory care in Federal facilities is not included, ambulatory care rates based on the U.S. population are underestimates.

Availability of Data

Published data are found in the National Center for Health Statistics Vital and health statistics, Series 13 and in Advance data. Data are available for public use on the National Center for Health Statistics Web site in an easy-to-use form with input statements.

National Hospital Ambulatory Medical Care Survey (NHAMCS)

Sponsor

Design

The National Hospital Ambulatory Medical Care Survey (NHAMCS) is a continuing series of nationally representative sample surveys of physicians in hospital emergency departments and outpatient departments in the United States. The survey includes all non-institutional, non-Federal, general, and short-stay hospitals with at least six beds staffed for patient use. The design is a multistage stratified probability sample of geographically defined areas, hospitals within these areas, clinics within the outpatient departments and emergency service areas within the emergency departments of these hospitals, and patient visits to these clinics and emergency service areas. Physicians are asked to complete a patient encounter form for a systematic sample of visits occurring during a randomly assigned 4-week reporting period.

The study design is described in: National Center for Health Statistics, McCaig LF, McLemore T. Plan and operation of the National Hospital Ambulatory Medical Care Survey. Hyattsville, Maryland: Public Health Service, 1994; DHHS Publication No. (PHS) 94-1310. (Vital and health statistics, Series 1, No. 34.)

Timeframe

Data have been collected annually since 1992. Data from 1992 through 2005 were used in this report.

Sample Size

A fixed panel of 600 hospitals was selected for the sample. A special supplement of 66 hospitals was added in 2003 to increase reliability of emergency department estimates for rural and proprietary hospitals. In 1992, the sample included about 36,000 emergency department visits and about 35,000 outpatient department visits.

Content Relevant to Digestive Diseases

Demographic data, reason for visit, physician’s diagnostic and therapeutic services ordered or provided, diagnoses and disposition decision, drugs prescribed, types of health care professionals seen, causes of injury where applicable, expected sources of payment, and characteristics of the hospital such as type of ownership are included.

Strengths

This survey complements the NAMCS, to provide more complete data on ambulatory care. The survey form is completed from provider records. Trend data are available for more than 10 years. International Classification of Diseases (ICD) codes are used for diagnoses.

Limitations

There may be more than one report per person, because the report reflects a visit rather than an individual. The sample size is small, so estimates of fewer than 200,000 are statistically unreliable. Because ambulatory care in Federal facilities is not included, ambulatory care rates based on the U.S. population are underestimates.

Availability of Data

Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP NIS)

Sponsor

Agency for Healthcare Research and Quality
U.S. Department of Health and Human Services
540 Gaither Road, Suite 2000
Rockville, MD 20850
301-427-1364
866-290-HCUP

Design

The Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP NIS) is a database of hospital inpatient stays. It utilizes a stratified sample of hospitals drawn from the subset of hospitals in the States that make their data available to HCUP. Hospitals are stratified by region, location/teaching status, bed-size category, and ownership. All discharges from sampled hospitals are included. The 2004 HCUP NIS includes all discharges from more than 1,000 hospitals, an approximate 20 percent stratified sample of U.S. community hospitals. HCUP NIS data are weighted to represent the annual discharges from non-Federal hospitals in the United States.

Several revisions have been made to the HCUP NIS sampling design since its inception. First, the sampling frame changed over time as more States made their data available to HCUP. The 1988 HCUP NIS was drawn from a sampling frame of eight States, representing 31 percent of all hospital discharges in the United States. In contrast, the sampling frame in recent years included 37 States, representing 85 to 90 percent of all hospital discharges in the United States. Second, in 1998, the sampling method was changed to better reflect the cross-sectional population of hospitals. The hospital stratification variables were redefined, short-term rehabilitation facilities were dropped from the target universe, and sampling preference was no longer given to prior-year NIS hospitals.

Timeframe

Data have been collected annually since 1988. Data from 2004 were used in this report.

Sample Size

The sample size is approximately 8 million hospital stays each year.

Content Relevant to Digestive Diseases

Data for each hospital stay include patient demographics (gender, age, race, median income for ZIP Code), admission and discharge status, length of stay, total charges, expected payment source, up to 15 diagnoses and 7 surgical procedures coded using International Classification of Diseases (ICD)-9-CM codes, and hospital characteristics (ownership, size, teaching status).

Strengths

The HCUP NIS is the largest all-payer inpatient care database in the United States. Data are weighted to be nationally representative of non-Federal hospitals in the United States. The HCUP NIS is the only national hospital database containing charge information on all patients, regardless of payer.

Limitations

Not all States participate. Not all participating States collect data on race-ethnicity; in 2004, race-ethnicity data were not collected by 11 participating States: Georgia, Illinois, Kentucky, Maine, Minnesota, Nebraska, Nevada, Ohio, Oregon, Washington, and West Virginia. The charge information is for the facility only; no information on physician fees is available. Data on medications are not supplied, although medication costs are included in the charge total.

Availability of Data

Summary statistics are published by the Agency for Healthcare Research and Quality. An online database, HCUP-Net, allows users to generate certain statistics easily. Selected data sets can be purchased for analysis.

National Hospital Discharge Survey (NHDS)

Sponsor

Hospital Care Statistics Branch
Division of Health Care Statistics
National Center for Health Statistics
Centers for Disease Control and Prevention
U.S. Department of Health and Human Services
3311 Toledo Road
Hyattsville, MD 20782
301-458-4321

Design

The National Hospital Discharge Survey (NHDS) is a continuing series of nationally representative sample surveys of hospitals in the United States. The survey includes all short-stay, non-Federal non-institutional hospitals having six or more beds for patient use and, before 1988, those in which the average length of stay for all patients was less than 30 days. In 1988, the scope was altered slightly to include all general and children’s general hospitals regardless of the length of stay. The design is a two-stage stratified probability sample of hospitals and discharges within hospitals. Beginning in 1985, two data collection procedures have been used: (1) a manual system in which data are abstracted from hospital records by the hospital staff or U.S. Census Bureau staff on behalf of the National Center for Health Statistics, and (2) an automated system in which machine-readable medical record data are purchased from commercial organizations, State data systems, hospitals, or hospital associations.

The study design is described in: National Center for Health Statistics, Dennison CF, Pokras R. Design and operation of the National Hospital Discharge Survey: 1988 redesign. Washington, D.C.: U.S. Government Printing Office, 2000; DHHS Publication No. (PHS) 2001-1315. (Vital and health statistics, Series 1, No. 39.)

Timeframe

Data have been collected annually since 1965. Data from 1979 through 2004 were used in this report.

Sample Size

Approximately 270,000 stays from about 500 hospitals each year constitute the sample.

Content Relevant to Digestive Diseases

Data in medical records for hospital discharges are collected for patient demographics (age, sex, race, ethnicity, and marital status), disposition, length of stay, expected source of payment, and for up to seven diagnoses and four surgical procedures coded to the International Classification of Diseases (ICD)-9-CM.

Strengths

The NHDS includes patients who die in the hospital and admissions from nursing homes, thereby producing more accurate estimates of utilization, diagnostic, and procedure data than those produced by household, self-reported interview surveys such as the National Health Interview Survey. Data are obtained directly from hospital records, thus minimizing underreporting. Data include up to seven discharge diagnoses and four procedure codes. ICD codes are used for diagnoses. Trend data are available for about 40 years.

Limitations

The data, which are based only on the factsheet of the hospital discharge record, may contain incomplete or inaccurate information, because there is no validation of condition. Extensive demographic and other health-related information is not available from hospital records. Recorded data reflect a discharge, not a person, so there may be more than one discharge per person for the same condition. Race is not coded on approximately 10 percent of records. Because hospitalizations in Federal facilities are not included, hospitalization rates based on the U.S. population are underestimates.

Availability of Data

Published data are found in the National Center for Health Statistics Vital and health statistics, Series 13 and in Advance data. Data are available for public use on data tapes, data diskettes, CD-ROMs and downloadable files from the National Center for Health Statistics Web site in an easy-to-use form with input statements.

Vital Statistics of the United States: Multiple Cause-of-Death Data

Sponsor

Mortality Statistics Branch
Division of Vital Statistics
National Center for Health Statistics
Centers for Disease Control and Prevention
U.S. Department of Health and Human Services
3311 Toledo Road, 7th floor
Hyattsville, MD 20782
301-458-4666

Design

Multiple cause-of-death mortality data from the National Vital Statistics System provide mortality data by multiple cause of death for all deaths occurring within the United States. Each record in the microdata is based on information abstracted from death certificates filed in vital statistics offices of each State and the District of Columbia. Causes of death were coded according to the International Classification of Diseases (ICD)-9 for 1979 through 1998, and according to ICD-10, beginning in 1999.

The study design is described in: National Center for Health Statistics, Data systems of the National Center for Health Statistics. Hyattsville, Maryland: Public Health Service, 1981; DHHS Publication No. (PHS) 82-1318. (Vital and health statistics: Series 1, No. 16.)

Timeframe

Data have been collected annually since 1968. Data from 1979 through 2004 were used in this report.

Sample Size

The sample is a 100 percent count of deaths in the United States.

Content Relevant to Digestive Diseases

Demographic data (age, sex, race, residence) and underlying and contributing causes of death are included.

Strengths

A complete count of deaths in the United States is included, along with 18 diagnoses. Trend data are available for more than 35 years. For digestive diseases with high mortality rates, such as cirrhosis, death records are the most comprehensive data source. Mortality statistics may be the only reliable data source for uncommon fatal conditions. Annual age-adjusted mortality rates are useful for examining trends over time, assuming case-fatality rates do not change significantly. Mortality rates for diseases that are usually fatal are often used as estimates of incidence rates when the latter are not available.

Limitations

Quality is dependent on the accuracy of death certificates, which may vary, according to condition. Chronic diseases that contribute to mortality are frequently underreported.

Availability of Data

Published data are found in: National Center for Health Statistics. Vital statistics of the United States, Vol. II, Mortality, Parts A and B; National vital statistics reports; and Vital and health statistics, Series 20. Data are available for public use on the National Bureau of Economic Research Web site in an easy-to-use form with input statements.

United States Population Estimates

Sponsor

Division of Population Projections
U.S. Census Bureau
From CDC Wonder
Centers for Disease Control and Prevention (CDC)
U.S. Department of Health and Human Services
1600 Clifton Road
Atlanta, GA 30333
404-639-3311
404-639-3534 and 800-311-3435 (public inquiries)

Design

The population estimates are mid-year (July 1) population counts by age, sex, and race. The counts are used with all national samples as the denominator for all estimates of rates. The year 2000 estimates are also used for age adjusting. These estimates are not used for cancer statistics from the Surveillance, Epidemiology, and End Results (SEER) program, which has its own population counts.

Timeframe

Estimates for 1979 through 2005 were used in this report.

Sample Size

The U.S. population is the sample.

Content Relevant to Digestive Diseases

Denominators are provided for calculating rate per 100,000 persons by age, race, and sex.

Surveillance, Epidemiology, and End Results (SEER) Program

Sponsor

Cancer Statistics Branch
Surveillance Research Program
Division of Cancer Control and Population Sciences
National Cancer Institute
National Institutes of Health
U.S. Department of Health and Human Services
6116 Executive Boulevard
Suite 504, MSC 8316
Bethesda, MD 20892-8316
301-496-8510

Design

A total of 17 population-based registries in the United States provide data on all residents diagnosed with cancer and follow-up information on all previously diagnosed patients. Data are compiled twice a year. Cancer mortality data are obtained from vital statistics for the entire United States.

Timeframe

Data have been collected annually since 1975. Data from 1979 through 2004 were used in this report.

Sample Size

Surveillance, Epidemiology, and End Results (SEER) program data for trends are 100 percent counts from Atlanta, Georgia; Connecticut; Detroit, Michigan; Hawaii; Iowa; New Mexico; San Francisco/Oakland, California; Seattle/Puget Sound, Washington; and Utah. SEER data for 2004 are 100 percent counts from the 9 registries above, plus Los Angeles, California; San Jose-Monterey, California; Rural Georgia; the Alaska Native Tumor Registry; Greater California; Kentucky; Louisiana; and New Jersey. National Center for Health Statistics mortality data are 100 percent counts from the entire United States.

Content Relevant to Digestive Diseases

Data regarding cancer incidence and mortality, including current and projected trends, are collected for selected sites, such as esophagus, stomach, colon, rectum, liver, and pancreas. Demographic data include age, sex, and race.

Strengths

SEER data are verified for quality and completeness. Data are estimated to be 99 percent complete from the registry sites. Mortality data are 100 percent counts of the United States. Trend data are available for about 30 years.

Limitations

SEER data represent only 17 areas of the country (and only 9 for trend data). Although the data are weighted to provide national estimates, these data are not statistically representative of the United States. Accuracy of cause of death coding for some gastrointestinal cancers is unknown.

Availability of Data

Data are published by the National Cancer Institute. Certain statistics can easily be generated online. Selected data sets are available for analysis.

Verispan

Sponsor

Verispan
800 Township Line Road, Suite 125
Yardley, PA 19067
267-685-4300 (telephone)
267-685-4400 (fax)

Design

The Vector One®: National (VONA) is a national-level prescription and patient tracking service that provides data on the numbers of prescription drugs dispensed by retail pharmacies. Data on nearly half of retail prescriptions dispensed in the United States are collected each month and are projected to be nationally representative through methods that stratify by geography, pay type, and class of trade.

The Physician Drug & Diagnosis Audit (PDDA) collects national-level disease state and associated therapy data from more than 3,100 office-based physicians representing 29 specialties. Physicians report all patient activity during one typical workday each month. Data collected are projected by region and specialty to be nationally representative of office-based physicians.

Diagnosis data from the PDDA and prescription data from the VONA are utilized by the Factor Processor to segment the number of prescriptions, units dispensed, or retail sales by disease state or diagnosis, to estimate total number of prescriptions and total costs for specific diseases.

Timeframe

The PDDA was established in 1990. Data from 2004 were used in this report.

Sample Size

Each month, data are captured on approximately half of all retail prescriptions dispensed in the United States. More than 3,100 office-based physicians report all patient activity during 1 typical workday each month.

Content Relevant to Digestive Diseases

The database includes International Classification of Diseases (ICD) codes for physician diagnoses that can be used to generate data on drugs prescribed for specific digestive diseases of interest.

Strengths

Data are nationally representative. Drug data are available for specific diseases defined by ICD codes.

Limitations

Estimates of total numbers of prescriptions and total costs for specific diseases are based on a factoring method applying information on physician prescribing practices to pharmacy data, rather than direct measurement. Number of prescriptions written by physicians may not be equivalent to number of prescriptions filled. Retail value of drugs may not be equivalent to the cost actually paid by patients. Prescription drugs from mail-order pharmacies are not included. Over-the-counter medications are not included.

Availability of Data

Summary statistics can be purchased through a contract with Verispan.

National Endoscopy Database (NED)/Clinical Outcomes Research Initiative (CORI)

Sponsor

Clinical Outcomes Research Initiative
3303 Southwest Bond Avenue, Suite 15C
Portland, OR 97239
888-786-2674 (toll-free telephone)
503-494-7401 (local telephone)
503 494-2699 (fax)
503-494-6522 (research services fax)

Design

U.S. endoscopy sites that voluntarily participate in the Clinical Outcomes Research Initiative (CORI) submit data on all endoscopic procedures performed at the sites.

Timeframe

CORI began in 1995 and is ongoing. Data from 2001 through 2005 were used in this report.

Sample Size

Currently, more than 275,000 procedure reports are received annually from 86 practice sites and more than 400 physicians in the United States. More than 1.7 million reports exist in the National Endoscopic Database (NED). Data used in this report came from 77 practices with 101 sites that performed a total of 542,650 colonoscopies, 270,957 esophagogastroduodenoscopies (EGD), 55,708 flexible sigmoidoscopies, 9,333 endoscopic retrograde cholangiopancreatographies (ERCP), and 6,945 endoscopic ultrasonographies (EUS), from 2001 through 2005.

Content Relevant to Digestive Diseases

Data collected include site and patient characteristics, indications for procedures, findings from procedures, completion rates, and unplanned event rates.

Strengths

The NED is the only U.S. national endoscopy database. Trends can be studied using data from a subset of “stable sites” that have participated for multiple consecutive years.

Limitations

Participation in CORI is voluntary; therefore, data from participating sites are not nationally representative.

Availability of Data

Through a contract with CORI, summary statistics can be purchased by persons outside the participating endoscopy sites.

National Nursing Home Survey (NNHS)

Sponsor

Long-Term Care Statistics Branch
Division of Health Care Statistics
National Center for Health Statistics
Centers for Disease Control and Prevention
U.S. Department of Health and Human Services
3311 Toledo Road
Hyattsville, MD 20782
301-458-4747

Design

The National Nursing Home Survey (NNHS) is a continuing series of nationally representative sample surveys of nursing homes in the United States. The survey includes all nursing homes with at least three beds that are either certified (by Medicare or Medicaid) or have a State license to operate as a nursing home. The design is a two-stage stratified probability sample of nursing homes and of current residents, persons discharged (deceased or alive) in the past year, and staff members within nursing homes. Data on residents and discharges are collected by interviewing a nurse who obtains the needed information from the medical records and the next of kin. The redesigned 2004 survey was administered using a computer-assisted personal interviewing (CAPI) system.

The study design is described in: Shimizu I. The 1985 National Nursing Home Survey design. Proceedings of the section on survey research methods, 1986 Annual Meeting of the American Statistical Association. Chicago: American Statistical Association, 1987.

Timeframe

Data have been collected in 1973–74, 1977, 1985, 1995, 1997, 1999, and 2004. Data from 2004 were used in this report.

Sample Size

In 2004, 1,500 facilities were selected from a sampling frame of 16,628 nursing homes, and 1,174 facilities participated. A total of 14,017 residents were sampled from the responding facilities, and 13,507 participated.

Content Relevant to Digestive Diseases

Prevalence of chronic conditions by primary diagnosis, medications taken, functional status, receipt of services (medical, nursing, and therapeutic), discharge health status and length of stay by diagnosis, cost of providing care by diagnosed condition, and sources of payment are available. Information on fecal incontinence is specifically gathered. Also included are demographic characteristics of residents, health and functional status before nursing home admission, lifetime use of nursing home care, and amount of Medicaid spending. Ostomy patients and patients with alcohol abuse or dependence can be identified. Bowel and bladder incontinence was also recorded.

Strengths

The survey provides a source of health status data on the subgroup of the population residing in and discharged from all types of nursing homes for whom health care data are otherwise difficult to obtain. Primary and secondary diagnoses by International Classification of Diseases (ICD) code, which include the diseases of the digestive system, are available for residents at admission and discharge. Reasons for admissions from short-stay hospitals by selected diagnostic-related groups for age 70 years or older include esophagitis, gastroenteritis and miscellaneous digestive disorders, and gastrointestinal hemorrhage.

Limitations

Residents with a primary diagnosis of digestive disease make up a small percentage of the nursing home population. The survey is of limited use for examining specific conditions, which tend to be coded only broadly.

Availability of Data

Published data are found in the National Center for Health Statistics Vital and Health Statistics, Series 13 and in Advance data. Data are available for public use on the National Center for Health Statistics Web site in an easy-to-use form with input statements.

National Home and Hospice Care Survey (NHHCS)

Sponsor

Design

The National Home and Hospice Care Survey (NHHCS) is a continuing series of surveys of home and hospice care agencies in the United States. The survey includes all agencies that are licensed or certified (Medicare or Medicaid). The design is a two-stage stratified probability sample of home health and hospice agencies and of current patients and discharges within agencies. Data are collected through personal interviews with administrators and staff.

The study design is described in: National Center for Health Statistics, Haupt BJ. Development of the National Home and Hospice Care Survey. Hyattsville, Maryland: Public Health Service, 1994; DHHS Publication No. (PHS) 94-1309. (Vital and health statistics, Series 1, No. 33.)

Timeframe

Data were collected in 1992, 1994, 1996, 1998, and 2000. Data from 2000 were used in this report.

Sample Size

In 2000, 1,800 agencies were selected from a sampling frame of 15,451 home health and hospice care agencies, and 1,425 agencies participated. The patient sample consisted of approximately 14,000 total patients, split between home health and hospice, and between current patients and discharged patients.

Content Relevant to Digestive Diseases

Admission and discharge diagnoses, referral and length of service, number of visits, patient charges, health status, reason for discharge, and types of services were provided.

Strengths

This survey provides a source of health status data on the subgroup of the population receiving care from, or discharged from, all types of home and hospice care agencies for whom health care data are otherwise difficult to obtain. Primary and secondary diagnoses by International Classification of Diseases (ICD) code, which include the diseases of the digestive system, are available for residents at admission and discharge.

Limitations

The exact coverage of the current patients is unclear. The weighted total may underestimate or overestimate the number of patients enrolled in a given year due to the rolling nature of the survey and the length of stay of patients. In addition, cost data represent billed amounts and not paid amounts.

Availability of Data

Medical Expenditure Panel Survey (MEPS)

Sponsor

Agency for Healthcare Research and Quality
U.S. Department of Health and Human Services
540 Gaither Road, Suite 2000
Rockville, MD 20850
301-427-1364

Design

The Medical Expenditure Panel Survey (MEPS) is a set of national surveys. The Household Component (HC) provides data from individual households and their members, which are supplemented by data from their medical providers. The HC collects data from a nationally representative subsample of households that participated in the prior year’s National Health Interview Survey (NHIS). The selected subsample undergoes several rounds of interviews during 2 full years of follow-up. A new sample of households is included in the survey each year.

The Medical Provider Component (MPC) surveys hospitals, physicians, home health care providers, and pharmacies identified by HC respondents to supplement and/or replace information received from the HC respondents.

The Insurance Component (IC), also known as the Health Insurance Cost Study, is a separate survey of a sample of private and public sector employers that collects data on employer-based health insurance plans.

Timeframe

Data have been collected annually since 1996. Data from 2004 were used in this report.

Sample Size

The 2004 HC surveyed 32,737 individuals from 13,018 families.

Content Relevant to Digestive Diseases

Data collected in the HC on each person in the household include demographic characteristics, health conditions, health status, use of medical services, charges and source of payments, access to care, satisfaction with care, health insurance coverage, income, and employment.

Data collected in the IC include the number and types of private insurance plans offered (if any), premiums, contributions by employers and employees, eligibility requirements, benefits associated with these plans, and employer characteristics.

Data utilized in the current report were from the HC and consisted of counts of the number of days of work missed due to illness, injury, or hospitalization.

Strengths

The sample is nationally representative of the U.S. population. Household data are supplemented by health care provider data. The survey includes data on number of days of work missed due to illness, injury, or hospitalization, which are unavailable from other data sources.

Limitations

Household data on medical conditions are by self-report.

Availability of Data

Summary data tables are published by the Agency for Healthcare Research and Quality on the MEPS Web site. An online database, MEPSnet, allows users to generate certain statistics easily. HC data files are available for public use. IC data files are not released publicly. MPC data files are not available for public release; information from these files is incorporated into the HC data files.

Last Reviewed January 2008

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