title: Assessing the Representativeness of Medical Expenditure Panel Survey Inpatient Utilization Data for Individuals With Psychiatric and Nonpsychiatric Conditions.
abstract: Sampling and reporting biases in the Medical Expenditure Panel Survey (MEPS) survey could render data on inpatient utilization that are not representative for individuals with severe psychiatric conditions. The authors assessed the representativeness of MEPS data on psychiatric inpatient utilization, by comparing MEPS estimates of total annual psychiatric and nonpsychiatric inpatient admissions and bed days, and mean length of stay, for nonelderly U.S. adults in calendar years 2005 to 2010 (N = 9,288) to estimates from the Nationwide Inpatient Sample (NIS), a nationally representative inpatient care database derived from hospitals' administrative records (N = 21,934,378). Compared with the NIS, the MEPS indicated 34% as many psychiatric admissions and 86% as many nonpsychiatric admissions, while mean psychiatric length of stay was greater in MEPS than in NIS. In MEPS data, underrepresentation of psychiatric inpatient utilization at community hospitals may result in measurement distortions for commonly used statistics on psychiatric inpatient utilization and costs.
authors.affiliation: U.S. Department of Veterans Affairs, Baltimore, MD, USA University of Maryland School of Medicine, Baltimore, MD, USA eslade@psych.umaryland.edu.
authors.forename: Eric P
authors.initials: EP
authors.lastname: Slade
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Howard H
authors.initials: HH
authors.lastname: Goldman
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY, USA New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Dixon
authors.affiliation: University of Maryland-Baltimore County, Baltimore, MD, USA.
authors.forename: Brent
authors.initials: B
authors.lastname: Gibbons
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Stuart
mesh_terms: D000328:Adult; D015982:Bias; D005260:Female; D019538:Health Care Surveys / Q000592:standards*; D005102:Health Expenditures / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: measurement error; mental health; psychiatric inpatient hospitalization; serious mental illness; stigma