A Guide to Comparing Health Care Expenditures in the 1996 MEPS to the 1987 NMES

Substantial changes in the organization, delivery, and financing of health care over the last decade, combined with data collection and methodological improvements in the 1996 Medical Expenditure Panel Survey (MEPS), pose special challenges in comparing expenditure estimates in MEPS with those in the 1987 National Medical Expenditure Survey (NMES). The 1987 NMES used charges as its fundamental expenditure concept, whereas the 1996 MEPS used actual payments as its expenditure measure. In spite of these differences, researchers and policymakers will want to be able to analyze trends in health care expenditures using these two surveys. We discuss these issues in detail and present a simple, straightforward adjustment method that can be applied to the 1987 NMES public use expenditure data to improve comparability to the MEPS. We base this adjustment method on an analysis of provider-reported payment data collected in NMES. We present several examples of the application of this method that illustrate the importance of the adjustments for analyses of trends in health care spending

The Shape of Demand: What Does It Tell Us about Direct-to-Consumer Marketing of Antidepressants?

Much of the debate surrounding Direct-to-Consumer Advertising (DTCA) of pharmaceuticals centers on whether DTCA conveys useful information to consumers or indiscriminately increases requests for the advertised medication. By identifying how DTCA changes the shape of the demand curve for antidepressants, we seek to infer the promotional objectives of manufacturers. Using data from the 1996-2003 Medical Expenditure Panel Survey (MEPS), we find that advertising shifts the demand curve for antidepressants outward and rotates it counter-clockwise. DTCA increases the probability that an individual will initiate use of antidepressants, particularly when out-of-pocket medication costs are low, but does not necessarily increase utilization levels among those already taking antidepressants. This is consistent with a promotional campaign that seeks to alert consumers to the product's existence, but conveys no real information that would allow them to learn their true match with the product.

Explaining Racial and Ethnic Disparities in Health Care

Abstract available at publisher's website

Implications of the Accuracy of MEPS Prescription Drug Data for Health Services Research

This paper assesses the quality of the Medical Expenditure Panel Survey (MEPS) drug data and the impact that misreporting prescription drug data has on descriptive and behavioral analyses. It does this by matching MEPS participants with Medicare Part D coverage during the period 2006–2007 to their Part D claims data. In the validation sample, the number of drug fills and total expenditures are reasonably accurate compared with claims. Household respondents tended to underreport the number of different drugs taken, but tended to overreport the number of fills of each drug. Behavioral analyses of the determinants of medication use and expenditures were largely unaffected because underreporting cut across most sociodemographic groups