Medical Conditions FileMedical Conditions File

General File StructureGeneral File Structure

Each record represents a unique condition or Each record represents a unique condition or procedure reported by a household respondentprocedure reported by a household respondent

Depending on the number of conditions reported, Depending on the number of conditions reported, persons may be represented on the filepersons may be represented on the file– onceonce– several times several times – not at all not at all

Reporting and Recording Reporting and Recording ConditionsConditions

Interviewer records verbatim text Interviewer records verbatim text reported by the household respondentreported by the household respondent

Open-ended questionsOpen-ended questions

Reporting and Recording Reporting and Recording ConditionsConditions

Respondents may report having the same Respondents may report having the same condition more than oncecondition more than once– Interviewer verifies that these are different Interviewer verifies that these are different

occurrences of the conditionoccurrences of the condition

– each unique episode of a condition is recorded only each unique episode of a condition is recorded only onceonce person may have more than one cold in a yearperson may have more than one cold in a year each cold has a separate recordeach cold has a separate record

Condition and Procedure Condition and Procedure Coding Coding

Coding and EditingCoding and Editing

– Fully specified ICD-9 CM codes (up to 5 digits)Fully specified ICD-9 CM codes (up to 5 digits)

– ICD-9 condition codes collapsed to 3 digits to maintain confidentialityICD-9 condition codes collapsed to 3 digits to maintain confidentiality

– Approximately 10% of condition codes are collapsed further by combining 2 or Approximately 10% of condition codes are collapsed further by combining 2 or more 3-digit codesmore 3-digit codes

– Procedure codes collapsed from fully specified (up to 4 digits) to 2-digit codesProcedure codes collapsed from fully specified (up to 4 digits) to 2-digit codes

– Approximately 3% of procedure codes are collapsed further by combining 2 or Approximately 3% of procedure codes are collapsed further by combining 2 or more 3-digit codesmore 3-digit codes

Clinical Classification Clinical Classification CodesCodes

Formerly Clinical Classification for Health Policy Formerly Clinical Classification for Health Policy Research (CCHPR)Research (CCHPR)

ICD-9 codes aggregated into clinically meaningful ICD-9 codes aggregated into clinically meaningful categoriescategories

Edited to preserve confidentiality Edited to preserve confidentiality

Priority ConditionsPriority Conditions

Designation based onDesignation based on– prevalenceprevalence

– expenseexpense

– relevance to policyrelevance to policy

ExamplesExamples– cancercancer

– diabetesdiabetes

– asthmaasthma

Priority ConditionsPriority Conditions

Specific Priority Condition QuestionsSpecific Priority Condition Questions– Date condition beganDate condition began– Round-specific questionsRound-specific questions

Was a doctor ever seen or talked to for the condition?Was a doctor ever seen or talked to for the condition? Did a provider recommend further treatment?Did a provider recommend further treatment?

– Follow-Up Questions in Later RoundFollow-Up Questions in Later Round Still being treated for this condition?Still being treated for this condition? How seriously does condition affect overall health and well-being?How seriously does condition affect overall health and well-being?

Accidents and InjuriesAccidents and Injuries

Ascertained at time of interviewAscertained at time of interview– date of accidentdate of accident

– place (work, home, school, etc.)place (work, home, school, etc.)

– cause (gun, vehicle, fall, fire, etc.)cause (gun, vehicle, fall, fire, etc.)

– whether or not the person has recovered whether or not the person has recovered from the injuryfrom the injury

Priority and Injury Priority and Injury ConditionsConditions

Date InformationDate Information– If a condition is both a priority condition and an injury, If a condition is both a priority condition and an injury,

date information is on injury date variables.date information is on injury date variables.

Previous Year’s InformationPrevious Year’s Information– Due to the overlapping panel design, Some conditions Due to the overlapping panel design, Some conditions

may have been first reported in the previous year. may have been first reported in the previous year. Unless it was a Priority Condition or was linked to an Unless it was a Priority Condition or was linked to an event in 2004, it may not appear on 2004 data file. event in 2004, it may not appear on 2004 data file.

Disability Flag VariablesDisability Flag Variables

Three Flag VariablesThree Flag Variables

– Missed work day (MISSWORK)Missed work day (MISSWORK)

– Missed school day (MISSSCHL)Missed school day (MISSSCHL)

– Day spent in bed (INBEDFLG)Day spent in bed (INBEDFLG)

Utilization VariablesUtilization Variables

Indicate Number of EventsIndicate Number of Events– ERNUM, HHNUM, IPNUM, OBNUM, OPNUM, RXNUMERNUM, HHNUM, IPNUM, OBNUM, OPNUM, RXNUM– Counts derived from event PUFsCounts derived from event PUFs

Events for Multiple ConditionsEvents for Multiple Conditions– Events may be associated with more than one conditionEvents may be associated with more than one condition– Example: One hospital stay for 3 conditionsExample: One hospital stay for 3 conditions

Fractured hip, fractured shoulder, concussionFractured hip, fractured shoulder, concussion

Weighted EstimatesWeighted Estimates

Condition file includes person-level weightsCondition file includes person-level weights

– Frequencies from this file will estimate the number of Frequencies from this file will estimate the number of times a condition was reported by the sample populationtimes a condition was reported by the sample population

– Number of persons reporting a condition can only be Number of persons reporting a condition can only be estimated at the person level estimated at the person level

Limitations of Condition Limitations of Condition Data Data

LimitationsLimitations– inaccurate or vague reports of conditioninaccurate or vague reports of condition

– clustering of ICD-9 codes in NEC (not clustering of ICD-9 codes in NEC (not elsewhere classified)elsewhere classified)

– one respondent provides information for one respondent provides information for the entire householdthe entire household

Linking to Other MEPS Linking to Other MEPS Files Files

ID VariablesID Variables– used to used to

identify and distinguish records on a fileidentify and distinguish records on a file match records in different filesmatch records in different files

– DUPERSID (person-level ID)DUPERSID (person-level ID)– CONDIDX (condition-level ID)CONDIDX (condition-level ID)– EVNTIDX (event-level ID)EVNTIDX (event-level ID)

but note PMED differences (LINKIDX, RXRECIDX)but note PMED differences (LINKIDX, RXRECIDX)

– CLNKIDX (condition-event link ID)CLNKIDX (condition-event link ID)

Condition SupplementsCondition Supplements

Priority ConditionsPriority Conditions– DiabetesDiabetes– AsthmaAsthma– HypertensionHypertension– Ischemic Heart DiseaseIschemic Heart Disease– ArthritisArthritis– StrokeStroke– EmphysemaEmphysema

Diabetes Care SAQ (DCS)Diabetes Care SAQ (DCS)