Information on cancer-related medical expenditures is based on analyses of 2 years of data from MEPS, 2001–2002. MEPS is co-sponsored by the Agency for Healthcare Research and Quality (AHRQ) and the National Center for Health Statistics (AHRQ, 2005). The household component of MEPS is a nationally representative survey of the U.S. civilian noninstitutionalized population that collects medical expenditure data at both the person and household levels.
The sample for the household component of MEPS was selected from respondents to the NHIS. MEPS is a panel survey, and data are collected through a precontact interview that is followed by a series of five rounds of interviews over 2 years. Two calendar years of medical expenditure and utilization data are collected from each household and captured using computer-assisted personal interviewing.
A history of cancer is not directly asked about as part of MEPS. Instead, the respondent is asked, “We’re interested in learning about health problems that may have bothered you since [date].” A history of cancer would be identified if the respondent identified cancer as a condition that had bothered him or her during the reference period. A cancer history would also be identified if a person sought care for cancer, had a bed day or disability day attributable to cancer, or took a prescription medicine for cancer (Personal communication, K. Beauregard, AHRQ, March 2, 2005). Medical conditions reported during the interview were coded using International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) codes. For analyses presented in this chapter, individuals reporting superficial skin cancer were excluded. MEPS may not identify individuals with a history of cancer if they do not have symptoms, are not seeking care for cancer, or are not taking cancer-related prescription medicines.
Expenditures in MEPS refer to payments for health care services. These expenditures are defined as the sum of direct payments for care provided during the year, including out-of-pocket payments and payments by private insurance, Medicaid, Medicare, and other sources. Payments for over-the-counter drugs, alternative care services, and phone contacts with medical providers are not included in MEPS total expenditure estimates. Expenditure data are from a sample of medical and pharmaceutical providers that provided care and medicines to individuals interviewed for the survey. These data from providers are used to improve the overall quality of expenditure data.
In addition to expenditures for total health services, expenses are classified into eight broad types of services and equipment: hospital inpatient, emergency room, outpatient services, medical provider visits, prescribed medicines, dental services, home health services, and other medical equipment and services. These categories are described below: