Announcements

New publications now available from AHRQ

The following publications and data products were released recently by the Agency for Healthcare Research and Quality. Print copies of most items are now available from AHRQ; others are available online only, as noted.

CERTs Annual Report, Year 4 (AHRQ Publication No. 04-0090).

The Centers for Education & Research on Therapeutics (CERTs) were established in 1999 by AHRQ in consultation with the U.S. Food and Drug Administration. The CERTs consist of a network of seven research centers and a coordinating center. The CERTs conduct research and provide education to advance the optimal use of drugs, medical devices, and biological products. Projects are aimed at advancing knowledge; informing health care providers, patients, and policymakers about that knowledge; and improving aspects of the health care system related to therapeutics. In their fourth annual report, the CERTs report on research in such areas as the safety of treatments for rheumatoid arthritis and examining better ways to monitor blood glucose levels in children with diabetes. Information dissemination continues in the areas of preventing antibiotic resistance and finding gaps in osteoporosis treatment. Researchers also examined health care delivery changes, such as effects of changing delivery of mental health care and using surveillance systems to improve safety. The report also discusses CERTs partnerships and collaborations, as well as resources produced by the program.

This report is available from the AHRQ Publications Clearinghouse.

Diabetes Care Quality Improvement. Resource Guide for State Action (AHRQ Publication No. 04-0072) and Workbook for State Action (AHRQ Publication No. 04-0073).

States can champion changes in health care delivery and best practices that can transform health care systems, reduce costs, and improve public health. For specific diseases, like diabetes, a number of States already have substantial programs underway that can shape and inform the development of new initiatives. AHRQ has released two new products to help State leaders implement or enhance quality improvement (QI) plans for diabetes for their States. These products were developed in consultation with diabetes control and prevention experts at all levels. The Resource Guide for State Action offers information for a range of participants—from elected leaders to local health care officials—in a State's QI efforts. It includes background information, analysis of State and national data, and guidance for developing a State QI plan, as well as an extensive listing of many ongoing national, State, and local programs to enhance diabetes care. The Workbook for State Action is an interactive companion to the Resource Guide. It presents exercises for State leaders to help them acquire the information and skills they need to implement health care QI programs in their State. Users will be able to compare plans and ongoing activities in their States with the Nation as a whole and with other States.

The Resource Guide is available from the AHRQ Publications Clearinghouse.

Employer-Sponsored Health Insurance: Trends in Cost and Access. Research in Action, Issue 17. M.W. Stanton and M.K. Rutherford. AHRQ Publication No. 04-0085.

The U.S. employer-based health insurance market provides insurance coverage to nearly two-thirds of the population under 65. This AHRQ report, which is based on Medical Expenditure Panel Survey (MEPS) data, provides information that decisionmakers can use in their efforts to make health insurance more affordable. The percent of employees who work in a place where insurance is offered has risen in recent years. However, many employers require that employees work full time or go through a waiting period in order to be eligible for coverage, and the percent of employees eligible to enroll where insurance is offered has gone down. Similarly, the percent of employees who work where insurance is offered and actually enroll has declined. The cost of the employee contribution is a major reason for declining enrollment, and low-wage workers are more sensitive to the size of the employee premium contribution. Hispanics, young adults, and near-elderly working women with health problems are the groups most likely to be uninsured.

This publication is available from the AHRQ Publications Clearinghouse.

Preventable Hospitalizations: A Window into Primary and Preventive Care, 2000. HCUP Fact Book 5 (AHRQ Publication No. 04-0056).

This new fact book examines a critical area of health care quality—potentially avoidable hospitalizations (i.e., hospitalizations that might be preventable with high quality primary and preventive care)—that may not be necessary if clinicians effectively diagnose, treat, and educate their patients and if patients actively participate in their care and adopt healthy lifestyle behaviors. The fact book presents information on preventable hospitalizations for 10 selected chronic conditions (e.g., hypertension), 5 acute conditions (e.g., dehydration), and 1 birth outcome (low-weight births). Information on variations across U.S. regions and hospitalizations among priority populations (including children, women, low-income, and rural residents) is presented in an overall context, and detailed statistics for each condition are also presented. Results are based on AHRQ's Prevention Quality Indicators applied to the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database. HCUP includes hospital discharge data drawn from 36 States representing 90 percent all hospital stays in the United States.

Medical Expenditure Panel Survey (MEPS). MEPS is the third in a series of nationally representative surveys of medical care use and expenditures sponsored by AHRQ. MEPS, which is cosponsored by the National Center for Health Statistics, collects detailed information on health care use and expenses, sources of payment and insurance coverage of individuals and families in the United States. MEPS comprises four component surveys: the Household Component, the Medical Provider Component, the Insurance Component, and the Nursing Home Component.

The following new MEPS data products and publications are now available from the AHRQ Web site at www.meps.ahrq.gov.

Data Products

Household Component Quality of Care Tables (2000, 2001). These tables are derived from MEPS-HC data on the following indicators of quality health care: medical care associated with diabetes, preventive health care services, barriers to health care services, access to health care services, and experiences during the delivery of health care services. The estimates provided in these tables may differ from estimates found in MEPS Statistical Briefs, the AHRQ National Quality Report, and other quality-related AHRQ publications. Any differences are due to a variety of factors, such as the use of different weights or data files from different points in time.

MEPS HC-067D: 2002 Hospital Inpatient Stays File (released October 2004). This public use file is drawn from the 2002 MEPS-HC and MEPS-MPC. It was released as an ASCII file with SAS format statements and in SAS transport format. The Hospital Inpatient Stays File provides detailed information on hospital inpatient stays. Data can be used to make estimates of inpatient hospital stay use and expenditures for calendar year 2002. This is an event-level data file containing characteristics associated with the hospital inpatient stay event such as: the date of the hospital inpatient stay, reason for the stay, types of services received, condition(s) and procedure(s) associated with the hospital stay, whether or not medicines were prescribed, and imputed expenditure data.

MEPS HC-067E: 2002 Emergency Room Visits File (released October 2004). This public use file is drawn from the 2002 MEPS-HC and MEPS-MPC. Released as an ASCII file with SAS (and SPSS) program statements and in SAS transport format, the Emergency Room Visits File provides detailed information on emergency room (ER) visits. Data can be used to make estimates of emergency room use and expenditures for calendar year 2002. The file contains characteristics associated with the ER visit such as: the date of the visit, types of care and services received, types of medicine prescribed during the visit, condition codes, expenditures, source of payment associated with the visit, and imputed expenditure variables.

MEPS HC-067F: 2002 Outpatient Department Visits (released October 2004). This public use file is drawn from the 2001 MEPS-HC and MEPS-MPC. It was released as an ASCII file with SAS (and SPSS) program statements and in SAS transport format. The Outpatient Visits File provides detailed information and can be used to make estimates of outpatient use and expenditures for calendar year 2001. It contains characteristics associated with the outpatient visit and imputed expenditure data such as the date of the visit, whether or not a doctor was seen, type of care received, type of services provided, expenditures and sources of payment, and imputed sources of payment.

MEPS HC-067G: 2002 Office-Based Medical Provider Visits File (release date October 2004). This public use data file is drawn from the 2002 MEPS-HC. Released as an ASCII file with SAS (and SPSS) program statements and in SAS transport format, the Medical Provider Visits File provides detailed information on office-based medical provider visits. Data are gathered from a nationally representative sample of the civilian, noninstitutionalized population of the United States and can be used to make estimates of office-based medical provider use and expenditures for calendar year 2002. This file contains characteristics associated with the office-based visit, such as: date of the visit, time spent with the provider, types of treatment and services received, types of medicine prescribed, condition codes, expenditures, source of payment associated with the visit, and imputed expenditure variables.

MEPS HC-065: MEPS Panel 5 (2000) Longitudinal Weight File (release date October 2004). This is a 2-year longitudinal file derived from the respondents to the MEPS Panel 5 2000 sample. The individuals in this data set represent those who were in the MEPS population for all or part of the 2000-2001 period. The file contains a weight variable (LONGWTP5) that, when applied to the people who participated in both 2000 and 2001, will enable the user to make national estimates of person-level changes in selected variables (e.g., health insurance, health status, use, and expenditures). In addition, LONGWTP5 can be used to develop cross-sectional type estimates for the civilian noninstitutionalized population in each year based on only the Panel 5 sample. To obtain analytic variables, the records on this file must be linked to the 2000 and 2001 MEPS public use data files using the sample person identifier (DUPERSID).

Data Update for MEPS HC-058: MEPS Panel 4 (1999) Longitudinal Weight File (Update Number 1, 10/29/04). The HC-058 data file has been updated to make stratum (VARSTRP4) and PSU (VARPSUP4) variables consistent with other longitudinal weight files, enabling the user to combine files for analytic purposes.

Projected MEPS Data and Related Documentation (2002-2008). These newly released files on the MEPS Web site provide projected health expenditures for each year between 2002 and 2008 by type of service and payment source for the civilian, noninstitutionalized household population and subgroups therein defined by selected demographic characteristics. The data have been projected from the 1996 MEPS data by reweighting the population using Vital Statistics data on demographic, mortality, and fertility changes in the U.S. population and Census predictions for changes into the future. Projected household health expenditures have been aligned to adjusted national health expenditures for each year from the National Health Accounts provided by the Centers for Medicare & Medicaid Services.

Publications

Statistical Brief #56: National Health Care Expenses in the U.S. Community Population, 2001. Using data from the MEPS-HC 2001, this Statistical Brief presents estimates on the health care expenses of the U.S. civilian noninstitutionalized (community) population in calendar year 2001. Health care expenses represent payments to hospitals, physicians, and other health care providers for services reported by respondents in the MEPS-HC.

Statistical Brief #55: Employee Contributions to Employer-Sponsored Health Insurance Coverage, 1997 versus 2002. This report, based on estimates from the MEPS-IC, shows the changes in employee contributions for both single and family (family of four) coverage from 1997 to 2002 in the private sector of the economy. Changes for employees working for small (fewer than 50 employees) and large (50 employees or more) firms are analyzed.

Statistical Brief #53: Employee Copays and Deductibles for Employer-Sponsored Health Insurance in 1999 and 2002. Using data from the 1999 and 2002 MEPS-IC, this report examines the values of copays and deductibles for employer-sponsored health insurance. Private-sector and public-sector (State and local government) employers are examined separately and within each sector by size of employer.

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