TY - JOUR
T1 - Measurement Error in Public Health Insurance Reporting in the American Community Survey
T2 - Evidence from Record Linkage
AU - Boudreaux, Michel H.
AU - Call, Kathleen Thiede
AU - Turner, Joanna
AU - Fried, Brett
AU - O'Hara, Brett
N1 - Publisher Copyright:
© Health Research and Educational Trust.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Objective Examine measurement error to public health insurance in the American Community Survey (ACS). Data Sources/Study Setting The ACS and the Medicaid Statistical Information System (MSIS). Study Design We tabulated the two data sources separately and then merged the data and examined health insurance reports among ACS cases known to be enrolled in Medicaid or expansion Children's Health Insurance Program (CHIP) benefits. Data Collection/Extraction Methods The two data sources were merged using protected identification keys. ACS respondents were considered enrolled if they had full benefit Medicaid or expansion CHIP coverage on the date of interview. Principal Findings On an aggregated basis, the ACS overcounts the MSIS. After merging the data, we estimate a false-negative rate in the 2009 ACS of 21.6 percent. The false-negative rate varies across states, demographic groups, and year. Of known Medicaid and expansion CHIP enrollees, 12.5 percent were coded to some other coverage and 9.1 percent were coded as uninsured. Conclusions The false-negative rate in the ACS is on par with other federal surveys. However, unlike other surveys, the ACS overcounts the MSIS on an aggregated basis. Future work is needed to disentangle the causes of the ACS overcount.
AB - Objective Examine measurement error to public health insurance in the American Community Survey (ACS). Data Sources/Study Setting The ACS and the Medicaid Statistical Information System (MSIS). Study Design We tabulated the two data sources separately and then merged the data and examined health insurance reports among ACS cases known to be enrolled in Medicaid or expansion Children's Health Insurance Program (CHIP) benefits. Data Collection/Extraction Methods The two data sources were merged using protected identification keys. ACS respondents were considered enrolled if they had full benefit Medicaid or expansion CHIP coverage on the date of interview. Principal Findings On an aggregated basis, the ACS overcounts the MSIS. After merging the data, we estimate a false-negative rate in the 2009 ACS of 21.6 percent. The false-negative rate varies across states, demographic groups, and year. Of known Medicaid and expansion CHIP enrollees, 12.5 percent were coded to some other coverage and 9.1 percent were coded as uninsured. Conclusions The false-negative rate in the ACS is on par with other federal surveys. However, unlike other surveys, the ACS overcounts the MSIS on an aggregated basis. Future work is needed to disentangle the causes of the ACS overcount.
KW - American Community Survey
KW - CHIP
KW - Medicaid
KW - survey methods
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U2 - 10.1111/1475-6773.12308
DO - 10.1111/1475-6773.12308
M3 - Article
C2 - 25865628
AN - SCOPUS:84955332436
SN - 0017-9124
VL - 50
SP - 1973
EP - 1995
JO - Health services research
JF - Health services research
IS - 6
ER -