JSM 2004 - Toronto

Abstract #301076

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Activity Number: 77
Type: Topic Contributed
Date/Time: Monday, August 9, 2004 : 8:30 AM to 10:20 AM
Sponsor: Section on Survey Research Methods
Abstract - #301076
Title: Examination of Skewed Health Expenditure Data from the Medical Expenditure Panel Survey
Author(s): William W. Yu*+ and Steven R. Machlin
Companies: Agency for Healthcare Research & Quality and Agency for Healthcare Research and Quality
Address: 540 Gaither Rd., Rockville, MD, 20850,
Keywords: medical expenditures ; skewness ; sample size ; confidence interval
Abstract:

The Medical Expenditure Panel Survey Household Component (MEPS-HC) is designed to provide nationally representative annual estimates of health care use, expenditures, sources of payment, and insurance coverage for the U.S. civilian noninstitutionalized population. The expenditure data from MEPS have been shown to exhibit a marked positive skewness, with a few high expenditure respondents and many low or zero expenditure respondents. As a consequence of this departure from the normal distribution, the frequency with which a conventional confidence interval for a MEPS expenditure estimate will not capture the true population parameter may be higher than the probability stated for the confidence interval. Based on repeated sample simulations using data from the 1996 to 2001 MEPS-HC, this paper evaluates and compares the "actual" probability achieved for confidence intervals derived from expenditure data by types of expenditure and varying sample sizes. The results are also compared to estimated confidence probabilities obtained from repeated sample simulations for other types of variables that do not exhibit as marked a positive skewness as health care expenditures.

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