Using Nationally Representative Datasets to Support Health-Related Issues at a Local and Policy Level

Mary M. Gerkovich, PhD, Victoria N. Ojo, MSB, Aaron J. Bonham, MS, Karen B. Williams, PhD, & William E. Lafferty, MD
UMKC School of Medicine, Department of Biomedical & Health Informatics
Introduction
There is increasing focus on using available data to address health issues and contribute to health care improvement. The impact of a locally-relevant health issue may best be understood if it is placed within the context of national data. This can provide a context for interpreting the health status and needs of a local patient population, and provide data important to policy issues at the local level. When the purpose of a project is to provide a comparison between local and national data at the person level, the Medical Expenditure Panel Survey (MEPS) dataset provides an excellent resource. This poster will present two exemplars using MEPS data to support projects that address health issues of importance to a safety-net health care system.

Exemplar 1
Goal Examine the extent to which health system services were disproportionately utilized by patients with increasing number of chronic conditions; and Compare data from a safety-net healthcare system to a nationally representative survey sample Methods Claims data from an urban, safety-net healthcare system (SNHS); records from 2008 MEPS survey; data from 2008 Measures Demographics: age, gender, ethnicity, insurance coverage Chronic Medical Conditions (CMC): asthma, COPD, diabetes, lipid disorder, hypertension, vascular disease, cancer, HIV/AIDS, sickle cell disease, mental illness Healthcare Utilization: outpatient visits, ED visits, hospital stays Results
Occurrence of CMC
100 100

Exemplar 2
Goal Use nationally representative survey dataset to compare cost and health status data of 2 genetically-determined chronic medical conditions cystic fibrosis (CF) and sickle cell disease (SCD) and a healthy population Methods MEPS survey: data from 1996-1997; 2002-2003; 2007-2008 Patients diagnosed with either SCD or CF, and individuals with no diagnoses Measures Demographics: age, gender, ethnicity, marital status, region, education level, insurance coverage Costs: direct (total health service expenditure), indirect (# days of disability or lost work/school) Health status: # of visits to various healthcare providers/sites Results

Summary of Conclusions
Nationally representative data can provide a valuable resource when addressing issues that have an impact on local health services. When doing research that incorporates national data, methods need to address the sampling structure used for the national survey, and creativity may be required to identify the common elements in disparate data sources.

Patients With Outpatient Visits

100000 90000

# Diagnosed
90000000 80000000 70000000 60000000 50000000 40000000 40000 30000000 20000000 10000000 0 CF SCD

NIH Research Funds - 2012 $ (estimated)

80 % of CMC Category

80

80000 70000

% of Total

60

60 60000 40 50000

40

20

20

30000 20000 0 1 2 3 4 5 10000 0

0 0 1 2 3 4 5 Number of CMC SNHS MEPS

0 Number of CMC SNHS MEPS

CF

SCD

Claims data were compiled by the Information Technology Division of Truman Medical Centers. MEPS data made available by Agency for Healthcare Research and Quality: Medical Expenditure Panel Survey; 2008 Household Survey. Rockville, MD: U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality 2008. [http:// meps.ahrq.gov/mepsweb/index.jsp] For further information, please contact Mary Gerkovich: gerkovichm@umkc.edu

Patients With ED Visits

100 100

Patients With Admissions

12000

Total Medical Expenditures - $

6000

Total Prescription Expenditures - $ (p=.02)

% of CMC Category

80 % of CMC Category

80

10000

5000

60

60

8000

4000

40

40

6000

3000

20

20

4000

2000

0 0 1 2 3 4 5 Number of CMC SNHS MEPS

0 0 1 2 3 4 5 Number of CMC SNHS MEPS

2000

1000

0 CF SCD

0 CF SCD