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Data Needs for the State Children's Health Insurance Program (2002)

Chapter: Appendix C Brief Descriptions of National Surveys Mentioned at the Workshop

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Suggested Citation:"Appendix C Brief Descriptions of National Surveys Mentioned at the Workshop." National Research Council. 2002. Data Needs for the State Children's Health Insurance Program. Washington, DC: The National Academies Press. doi: 10.17226/10416.
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Appendix C
Brief Descriptions of National Surveys Mentioned at the Workshop

The following descriptions are taken largely from the web sites cited.

Current Population Survey, March Supplement: The Current Population Survey (CPS) is a monthly survey of about 50,000 households conducted by the Bureau of the Census for the Bureau of Labor Statistics. The survey has been conducted since 1940. The CPS is the primary source of information on the labor force characteristics of the U.S. population. The sample is scientifically selected to represent the civilian noninstitutionalized population. For the annual March income supplement, the CPS asks respondents about income received during the previous calendar year. This serves as the basis for estimating the number of children who may be eligible for Medicaid and SCHIP. The sample provides estimates for the nation as a whole and serves as part of model-based estimates for individual states and other geographic areas. CPS data are used by government policy makers and legislators as important indicators of the nation’s economic situation and for planning and evaluating many government programs. CPS data are also used by the press, students, academics, and the public. CPS data provide state-level estimates of the low-income population to the SCHIP community.

Additional information can be found at: http://www.bls.census.gov/cps/overmain.htm.

Medical Expenditure Panel Survey: The Agency for Healthcare Research

Suggested Citation:"Appendix C Brief Descriptions of National Surveys Mentioned at the Workshop." National Research Council. 2002. Data Needs for the State Children's Health Insurance Program. Washington, DC: The National Academies Press. doi: 10.17226/10416.
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and Quality (AHRQ) began fielding the Medical Expenditure Panel Survey (MEPS) on a continuing basis in March 1996. MEPS is conducted in conjunction with the National Center for Health Statistics (NCHS) and through contracts with Westat, a survey research firm headquartered in Washington, DC, and the National Opinion Research Center, which is affiliated with the University of Chicago. MEPS is a vital resource designed to continually provide policy makers, health care administrators, businesses, and others with timely, comprehensive information about health care use and costs in the United States and to improve the accuracy of their economic projections. MEPS collects data on the specific health services that are used, how frequently they are used, the cost of these services, and how they are paid for, as well as data on the cost, scope, and breadth of private health insurance held by and available to the U.S. population. For purposes of the current study, MEPS data have been combined for the period 1996-1999 to obtain a sample of 35,000 children.

MEPS Fact Sheet. February 2001. Agency for Healthcare Research and Quality, Rockville, MD. Additional information can be found at: http://www.meps.ahrq.gov/whatismeps/bulletin.htm.

National Health Interview Survey: The National Health Interview Survey (NHIS) is the principal source of information on the health of the civilian noninstitutionalized population of the United States and is one of the major data collection programs of the National Center for Health Statistics (NCHS). The National Health Survey Act of 1956 provided for a continuing survey and special studies to secure accurate and current statistical information on the amount, distribution, and effects of illness and disability in the United States and the services rendered for or because of such conditions. The survey referred to in the act, now called the National Health Interview Survey, was initiated in July 1957. Since 1960, the survey has been conducted by NCHS, which was formed when the National Health Survey and the National Vital Statistics Division were combined. NHIS data are used widely throughout the U.S. Department of Health and Human Services (DHHS) to monitor trends in illness and disability and to track progress toward achieving national health objectives. The data are also used by the public health research community for epidemiological and policy analysis, determining barriers to accessing and using appropriate health care, and evaluating federal health programs. The NHIS data for 2001 revealed that around 11 percent of children under the age of 18 lacked

Suggested Citation:"Appendix C Brief Descriptions of National Surveys Mentioned at the Workshop." National Research Council. 2002. Data Needs for the State Children's Health Insurance Program. Washington, DC: The National Academies Press. doi: 10.17226/10416.
×

health insurance. The MEPS, described above, uses the NHIS as the basis for its sample.

Additional information can be found at: http://www.cdc.gov/nchs/about/major/nhis/hisdesc.htm.

National Survey of America’s Families: Conducted by the Urban Institute, the National Survey of America’s Families provides a comprehensive look at the well-being of adults and children and reveals sometimes striking differences among the 13 states studied in depth. The survey provides quantitative measures of quality of life in America, paying particular attention to low-income families. The survey includes a sample of approximately 1,800 families with children under 18 in each of 13 states: Alabama, California, Colorado, Florida, Massachusetts, Michigan, Minnesota, Mississippi, New Jersey, New York, Texas, Washington, and Wisconsin. Together, these states comprise more than half the nation’s population and represent a broad range of fiscal capacity, child well-being, and approaches to government programs. Data from 1997 and 1999 are now available. The survey collected data on health insurance, access to care, and the health status of children. In 1999, most SCHIP programs were not yet mature, so that survey data provide only limited information on SCHIP coverage.

Additional information can be found at: http://newfederalism.urban.org/nsaf/.

State and Local Area Integrated Telephone Survey: The National Center for Health Statistics developed the State and Local Area Integrated Telephone Survey (SLAITS) initially for the National Immunization Survey. SLAITS was originally designed to include a sample of almost one million households per year to produce estimates of the vaccination coverage of children age 19-35 months. It has since been made available to collect important health care data at the state and local levels to meet various program and policy needs in an ever-changing health care system. The survey is funded through sponsorship of specific questionnaire modules. Sponsors include both government agencies and nonprofit organizations. Just as public and private organizations collaborate in the planning and delivery of health care services, SLAITS facilitates additional collaboration leading to more complete data for informed public health policy decisions. Decision makers require quality health data for program development and policy-making activities. SLAITS research areas range from health insurance coverage and access to care to perceived health status and utilization of

Suggested Citation:"Appendix C Brief Descriptions of National Surveys Mentioned at the Workshop." National Research Council. 2002. Data Needs for the State Children's Health Insurance Program. Washington, DC: The National Academies Press. doi: 10.17226/10416.
×

services to measures of child well-being. SLAITS addresses state-specific data needs with customized questions and specific domains of interest. It also targets population subgroups such as persons with specific health conditions or from low-income households. SLAITS is an ongoing survey for child immunization efforts, but it is not conducted at regular intervals for other specific studies. Rather, survey sponsors may implement SLAITS surveys at any time. Typically, it takes at least 3 to 6 months to develop, program, and test a new survey questionnaire before data collection can begin.

Additional information can be found at: http://www.cdc.gov/nchs/slaits.htm.

Survey of Income and Program Participation: Conducted by the U.S. Census Bureau, the Survey of Income and Program Participation (SIPP) collects sources and amounts of income, labor force information, program participation and eligibility data, and general demographic characteristics to measure the effectiveness of existing federal, state, and local programs. The survey also estimates future costs and coverage for government programs, such as food stamps, and provides improved statistics on the distribution of income in the country. The survey design is a continuous series of national panels, with sample size ranging from approximately 14,000 to 36,700 interviewed households. The duration of each panel ranges from 2½ to 4 years. The SIPP content is built around a “core” of labor force, program participation, and income questions designed to measure the economic situation of persons in the United States. These questions expand the data currently available on the distribution of cash and noncash income and are repeated at each interviewing wave. The survey uses a 4-month recall period, with approximately the same number of interviews being conducted in each month of the 4-month period for each wave. Interviews are conducted by personal visit and by decentralized telephone. The survey has been designed also to provide a broader context for analysis by adding questions on a variety of topics not covered in the core section. These questions are labeled “topical modules” and are assigned to particular interviewing waves of the survey. Topics covered by the modules include personal history, child care, wealth, program eligibility, child support, disability, school enrollment, taxes, and annual income. Over the years, SIPP has included data that have indicated considerable volatility in children’s health insurance coverage.

Additional information can be found at: http://www.sipp.census.gov/sipp/sippov98.htm.

Suggested Citation:"Appendix C Brief Descriptions of National Surveys Mentioned at the Workshop." National Research Council. 2002. Data Needs for the State Children's Health Insurance Program. Washington, DC: The National Academies Press. doi: 10.17226/10416.
×
Page 57
Suggested Citation:"Appendix C Brief Descriptions of National Surveys Mentioned at the Workshop." National Research Council. 2002. Data Needs for the State Children's Health Insurance Program. Washington, DC: The National Academies Press. doi: 10.17226/10416.
×
Page 58
Suggested Citation:"Appendix C Brief Descriptions of National Surveys Mentioned at the Workshop." National Research Council. 2002. Data Needs for the State Children's Health Insurance Program. Washington, DC: The National Academies Press. doi: 10.17226/10416.
×
Page 59
Suggested Citation:"Appendix C Brief Descriptions of National Surveys Mentioned at the Workshop." National Research Council. 2002. Data Needs for the State Children's Health Insurance Program. Washington, DC: The National Academies Press. doi: 10.17226/10416.
×
Page 60
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The State Children's Health Insurance Program (SCHIP) was established by Congress to provide health insurance to uninsured children whose family income was too high for Medicaid coverage but too low to allow the family to obtain private health insurance coverage. The enabling legislation for SCHIP, included in the Balanced Budget Act of 1997, made available to states (and the District of Columbia) almost $40 billion over a 10-year period for this program. Like Medicaid, SCHIP is a joint federal-state program, with funding from both sources, but it is implemented by the states. Thus, there are SCHIP programs in all of the states and the District of Columbia.

The National Research Council, through the Committee on National Statistics, was asked to explore some of the ways in which data analysis could be used to promote achievement of the SCHIP goal of expanding health insurance coverage for uninsured children from low-income families. To inform its work, the panel for this project held a workshop to bring together state SCHIP officials and researchers to share findings and methods that would inform the design, implementation, and evaluation of SCHIP at the state and national levels. In keeping with this charge, this report is limited to discussions at the workshop. It does not attempt to provide a summary of all the state programs nor a comprehensive review of the literature.

Data Needs for the State Children's Health Insurance Program concludes that data are insufficient in the individual states to provide a clear picture of the impact of SCHIP on the number of children who are eligible for the program, the rate at which eligible children are enrolled in the program, and the rate at which they are retained in the program once enrolled. This situation is due, in part, to the fact that sample sizes in national surveys are too small to provide detailed data for individual states. In addition, the great amount of movement of children among health insurance categories—Medicaid, SCHIP, private insurance, or no insurance at all—makes it difficult for states to count the number of children in specific categories at a particular point in time.

The panel specifies a number of practices that could be implemented to improve the overall functioning of SCHIP and the ability of policy makers to evaluate the program. Foremost among these are: (1) developing more uniform ways of estimating eligibility and health insurance coverage among the states; (2) sharing among the states effective methods for outreach; (3) taking qualitative information into account, in addition to quantitative information, in assessing variation among states in enrollment and disenrollment; and (4) implementing longitudinal studies to track the movement of children among the various insurance statuses.

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