Measuring health care costs of individuals with employer-sponsored health insurance in the U.S.: A comparison of survey and claims data.
Measuring health care costs of individuals with employer-sponsored health insurance in the U.S.: A comparison of survey and claims data.
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DOI：
10.3233/sji-2012-0743
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发表时间：
2012-01-01
影响因子：
--
通讯作者：
Rosen, Allison B
中科院分区：
文献类型：
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作者：
Aizcorbe, Ana;Liebman, Eli;Rosen, Allison B
作为美国具有全国代表性的核心卫生支出调查，医疗支出小组调查（MEPS）越来越多地被统计机构用于追踪疾病支出。然而，虽然MEPS提供了丰富的数据，但其样本量小，无法检查除最普遍的健康状况外的所有支出。为了克服这个问题，统计机构已经转向其他公共数据源，如医疗保险和医疗补助索赔数据，如果有的话。对于那些拥有雇主赞助保险的人，没有可比较的公开数据。虽然大型专有索赔数据库可能是一种选择，但其支出估算的相对准确性尚不清楚。这项研究比较了MEPS和MarketScan对雇主赞助保险的个人每年人均医疗保健支出的估计。两种数据来源的总支出和年度人均支出分布都存在差异，MEPS的估计平均比MarketScan的估计低10%。这些差异似乎是高支出案例代表性不足和其余支出分配低估的结果。
As the core nationally representative health expenditure survey in the United States, the Medical Expenditure Panel Survey (MEPS) is increasingly being used by statistical agencies to track expenditures by disease. However, while MEPS provides a wealth of data, its small sample size precludes examination of spending on all but the most prevalent health conditions. To overcome this issue, statistical agencies have turned to other public data sources, such as Medicare and Medicaid claims data, when available. No comparable publicly available data exist for those with employer-sponsored insurance. While large proprietary claims databases may be an option, the relative accuracy of their spending estimates is not known. This study compared MEPS and MarketScan estimates of annual per person health care spending on individuals with employer-sponsored insurance coverage. Both total spending and the distribution of annual per person spending differed across the two data sources, with MEPS estimates 10 percent lower on average than estimates from MarketScan. These differences appeared to be a function of both underrepresentation of high expenditure cases and underestimation across the remaining distribution of spending.