Abstract
To test whether a change from a telephone to mail and Internet survey in January 2018 affected the sample composition and uninsured estimates in the Gallup-Sharecare Well-Being Index. Gallup-Sharecare Well-Being Index (2013-2018). Regression discontinuity analysis identified changes after the survey redesign in the estimated U.S. uninsured rate (adults 18-64) and in the sample's demographic composition. After the survey redesign, the estimated uninsured rate fell 5.3 percentage points (P<0.001), respondents were older and disproportionately white, more likely to have a college degree, and had higher average incomes. These changes were modestly reduced by survey weights. The shift to a mail survey (with a web option) led to an older, more educated sample with fewer minorities, and a significant break in trend in the estimated uninsured rate.
Highlights
After the passage of the Affordable Care Act (ACA), the Gallup-Sharecare Well-BeingIndex (WBI – previously the Gallup-Healthways Well-Being Index) served as a valuable source of timely data on trends in insurance coverage and other health measures.[1,2,3,4] From 2008-2017, the WBI was administered as a daily, random-digit dialing telephone survey, but on January 1, 2018, the methodology changed to a monthly mail- and web-based approach
A previous validation study demonstrated that the phone-based survey produced relatively similar estimates of insurance coverage, access to care, and health status compared to five large governmentsponsored surveys.[5]
The unweighted trend drops from over 13% in October 2017 to about 7% in January 2018, the period when the survey shifted from phone-based to mail-based. This decline is roughly equal to the size of the more gradual change that occurred in the first six months after the ACA’s 2014 coverage expansion first took effect
Summary
Index (WBI – previously the Gallup-Healthways Well-Being Index) served as a valuable source of timely data on trends in insurance coverage and other health measures.[1,2,3,4] From 2008-2017, the WBI was administered as a daily, random-digit dialing telephone survey, but on January 1, 2018, the methodology changed to a monthly mail- and web-based approach. A previous validation study demonstrated that the phone-based survey produced relatively similar estimates of insurance coverage, access to care, and health status compared to five large governmentsponsored surveys.[5] the survey’s 2018 redesign may have impacted the sample composition and the WBI’s ability to accurately estimate changes in insurance coverage over time. Other large surveys may opt to change data collection tactics to improve response rates
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