Center for Studying Health System Change

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CTS Household Survey and HSC Health Tracking Household Surveys

 
 

Design and Methods

 
 

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Household Survey

 
 

Followback Survey

 
 

Physician Survey

 
 

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To track changes in health care access, utilization, coverage, costs, and other experiences with the health care system HSC periodically conducts a nationally representative household survey. The most recent round of the survey, conducted in 2010, includes information on 9,200 families and roughly 17,000 individuals, and is nationally representative of the civilian, non-institutionalized population. The response rates were 46 percent and 29 percent for the landline and cell phone samples, respectively. Prior rounds of the survey conducted between 1996 and 2007 included approximately 9,400-33,000 families and 18,000-60,000 individuals, and comprised representative samples of the nation and—between 1996 and 2003—60 randomly selected communities.

The survey is conducted by telephone. Prior rounds of the survey also included a small sample of households without telephones. Household Survey topics include type of health insurance coverage, utilization of medical services (e.g., number of physician visits and number of emergency room visits), usual source of care, perceived quality of care, health status, employer health insurance offerings, problems paying medical bills,  consumer-directed health care, health information-seeking, care coordination and assessments of care quality for chronic conditions. The 2010 survey also included more detailed questions about respondents’ usual source of care, health care providers’ use of computers or handheld devices during office visits and respondents’ attitudes toward health insurance.

Household Survey topics include type of health insurance coverage, utilization of medical services (e.g., number of physician visits and number of emergency room visits), usual source of care, perceived quality of care, health status, employer health insurance offerings, and problems paying medical bills, consumer-directed health care, health information-seeking, care coordination and assessments of care quality for chronic conditions. The 2010 survey also included more detailed questions about respondentsí usual source of care, health care providersí use of computers or handheld devices during office visits and respondentsí attitudes toward health insurance.

The six household surveys were conducted in 1996-97, 1998-99, 2000-01, 2003, 2007 and 2010.

Examples of Survey Questions

  • Was there any time during the past 12 months when you put off or postponed getting medical care you thought you needed?
  • Is there a place that you usually go to when you are sick or need advice about your health?
  • During the past 12 months, did you have any problems paying medical bills?
  • During the past 12 months, did you look for or get information about a personal health concern on the internet?
  • Did you use information from comparative reports on cost and quality to choose a specialist?
Examples of Analyses That Can Be Done with the Data
  • Making national population estimates of insurance coverage, access to and perceived quality of care, service use, and other measures in the survey.
  • Conducting behavioral analyses and health policy simulations that are generalizable to the U.S. population.
  • Conducting analyses of the effect of state policy and other characteristics by merging state- level data from other sources using state identifiers on the file (1996-2003 only).
  • Conducting market-level analysis including data from other sources using county identifiers on the file for the areas in which the survey was conducted (1996-2003 only).
  • Analyzing change for the years 1996-97, 1998-99, 2000-01, 2003, 2007 and 2010. It is important to note that using the 2007 and/or 2010 data permits national-level estimates only.

Data Files for Public Use. Public use and restricted use data files are available for researchers to do their own analysis of this survey. For more information, read about Using the HSC Data Files.

Finding Additional Information. Additional information about this survey can be found in various HSC Technical Publications. The user's guides for this survey provide summary information about the CTS in general and this survey in particular. The user's guides also include information about how to use the data file, as well as appendices with copies of the survey instruments. The codebooks list the variables on the data files and their frequencies. The methodology reports have detailed information documenting how the survey was conducted.


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