Health Insurance Dynamics: Methodological Considerations and a Comparison of Estimates from Two Surveys
Health Insurance Dynamics: Methodological Considerations and a Comparison of Estimates from Two Surveys
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DOI：
10.1111/1475-6773.12449
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发表时间：
2016-10-01
影响因子：
3.4
通讯作者：
Mishra, Pranita
中科院分区：
文献类型：
--
作者：
Graves, John A.;Mishra, Pranita
目标。强调研究保险动态的关键方法问题，并比较两种常用调查的估计。数据来源/研究设置。2001年至2011年间，在医疗支出小组调查和收入和计划参与调查中抽样的非老年无保险成年人和儿童。研究设计。我们使用非参数Kaplan-Meier方法来估计未投保期分布的分位数（25、50和75百分位数）。我们比较了通过调查和不同方法方法获得的估计值，以解决诸如损耗、接缝偏差、审查和截断以及调查加权方法等问题。数据收集/提取方法。所有数据均来自可公开获得的住户调查。主要的发现。估计未投保的法术持续时间在MEPS比在SIPP观察到的更长。在2001年至2011年期间，拼写持续时间几乎没有变化，在MEPS中，成人的平均持续时间为14个月，儿童为5-7个月，在sipp中，成人为8个月，儿童为4个月。使用小组调查数据来研究保险动态提出了一套独特的方法挑战。研究人员在选择哪种调查最适合他们的研究目标时，应该考虑关键的分析和调查设计权衡。
Objective. To highlight key methodological issues in studying insurance dynamics and to compare estimates across two commonly used surveys.Data Sources/Study Setting. Nonelderly uninsured adults and children sampled between 2001 and 2011 in the Medical Expenditure PanelSurvey and the Survey of Income and Program Participation.Study Design. We utilized nonparametric Kaplan-Meier methods to estimate quantiles (25th, 50th, and 75th percentiles) in the distribution of uninsured spells. We compared estimates obtained across surveys and across different methodological approaches to address issues like attrition, seam bias, censoring and truncation, and survey weighting method.Data Collection/Extraction Methods. All data were drawn from publicly available household surveys.Principal Findings. Estimated uninsured spell durations in the MEPS were longer than those observed in the SIPP. There were few changes in spell durations between 2001 and 2011, with median durations of 14months among adults and 5-7months among children in the MEPS, and 8months (adults) and 4months (children) in the SIPP.Conclusions. The use of panel survey data to study insurance dynamics presents a unique set of methodological challenges. Researchers should consider key analytic and survey design trade-offs when choosing which survey can best suit their research goals.