Use of the integrated health interview series: trends in medical provider utilization (1972-2008).

Mike Davern,Miriam L King,Michel Boudreaux,Lynn A Blewett,Brian Lee

doi:10.1186/1742-5573-9-2

Abstract

The Integrated Health Interview Series (IHIS) is a public data repository that harmonizes four decades of the National Health Interview Survey (NHIS). The NHIS is the premier source of information on the health of the U.S. population. Since 1957 the survey has collected information on health behaviors, health conditions, and health care access. The long running time series of the NHIS is a powerful tool for health research. However, efforts to fully utilize its time span are obstructed by difficult documentation, unstable variable and coding definitions, and non-ignorable sample re-designs. To overcome these hurdles the IHIS, a freely available and web-accessible resource, provides harmonized NHIS data from 1969-2010. This paper describes the challenges of working with the NHIS and how the IHIS reduces such burdens. To demonstrate one potential use of the IHIS we examine utilization patterns in the U.S. from 1972-2008.

Highlights

The National Health Interview Survey (NHIS) is an annual cross-sectional household survey of the civilian, non-institutionalized U.S population sponsored by the National Center for Health Statistics
Integrated Health Interview Series (IHIS) multiplies the value of NHIS data by allowing researchers to make consistent comparisons throughout four decades of dramatic change in public health, and to study the health status of Americans as a dynamic process
An applied example of the IHIS As a concrete example of the power of IHIS to unlock the full potential of the NHIS, we examine a healthcare utilization measure to highlight changes in provider utilization over time

Summary

Introduction

The National Health Interview Survey (NHIS) is an annual cross-sectional household survey of the civilian, non-institutionalized U.S population sponsored by the National Center for Health Statistics. Despite the temporal depth of this rich data resource, multi-year analysis of the NHIS has been limited to a few researchers who have had the time and temerity to tackle linking the annual survey data across years Studies such as Cohen et al.’s 48 year study of health insurance coverage [1], Chay and colleagues’ investigation of hospital utilization, mortality, and the introduction of Medicare [2], or Reither et al.’s 26 year cohort study of obesity [3] were once only possible by NCHS staff or by study. IHIS multiplies the value of NHIS data by allowing researchers to make consistent comparisons throughout four decades of dramatic change in public health, and to study the health status of Americans as a dynamic process. In coming years, researchers and policy makers will have a special need for rich health data, such as the IHIS, to fully understand the effects of the Affordable Care Act-the most dramatic change to the American health system since the introduction of Medicare and Medicaid

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