NMES-1 and NMES-2 asked a nationally representative sample of the U.S. civilian population about medical care use, costs of health care services and payments for medical expenditures in 1977 and 1987, respectively. NMES-1, formerly known as the National Medical Care Expenditure Survey (NMCES), was conducted for the National Center for Health Services Research (NCHSR). The Center for General Health Services Intramural Research, Agency for Health Care Policy and Research sponsored NMES-2.

For more information on NMES, see the following:

NORC's Role in NMES
NMES-1
NMES-2
Comparability with Other Studies
NMES Data Availability
Publications

NORC's Role in NMES

NORC participated in NMES as a subcontractor responsible for many facets of the study. Areas of responsibility included data collection and processing.

NMES-1

NMES-1 consists of three component surveys: Household, the Medical Provider Survey, and the Health Insurance/Employer Survey.

The Household Survey, conducted over six rounds between 1977 and 1978, interviews 13,500 randomly selected households about their demographic background, medical use, costs and payments. The other two NMES-1 components are based on the data collected in the Household survey.

The Medical Provider component questions a sample of doctors and other medical care providers who were identified by Household survey respondents about patient visits, diagnoses, charges, and payments. The Medical Provider component used a sample of approximately 13,500 medical care providers and its data were collected through a mail survey.

The Health Insurance/Employer component supplements and corroborates data on medical insurance coverage provided by respondents to the Household survey.

NMES-2

The 1987 NMES consists of three key components: Household Survey, Survey of American Indians and Alaskan Natives, and the Institutional Population Survey.

The Household Survey inquires about household composition, employment, insurance coverage, the access to and use of medical care, and the costs and expenditures for medical care services. The sample for the Household component consists of 14,000 households to represent the U.S. civilian, non-institutionalized population. The Household component oversamples policy relevant groups such as the poor, blacks, Hispanics, and those who were likely to need or use long term medical care like the elderly and the mentally retarded. Data were collected by in-person and telephone interviews and a self-administered questionnaire.

The Survey of American Indians and Alaskan Natives estimates medical care use and costs for those who are eligible to use the Indian Health Service to obtain medical care. NMES-2 developed a separate household sample of the American Indian and Alaskan Native populations. This sample consists of approximately 2,000 individuals who were living on reservations. The data were collected through in-person interviews.

The Institutional Population Component surveys health care providers in nursing homes and in homes for the mentally retarded. Also, it interviews the relatives of patients who reside in these homes about medical care costs and services. To qualify for inclusion in the Institutional Population Survey, a respondent had to have spent at least one night in a nursing home or mental facility during 1987. The sample for the Institutional Population component consists of approximately 11,000 individuals and 1,200 institutions. The data collection methods included computer assisted telephone interviewing and in person interviewing.

The three main components described above provide the basis on which two additional surveys were developed: the Health Insurance Plans Survey and the Medial Provider Survey. Each of these supplemental surveys corroborate and expand upon the data provided by respondents to the main components. In the Household and Native American and Alaskan Native components, respondents identified their employers, health insurance companies and other groups from which they purchased medical insurance coverage. These groups comprise the Health Insurance Plan Survey sample. The sample for the Medical Provider Survey consists of 25% of medical providers identified by respondents to the Household and Native American and Alaskan Native components. Both supplemental surveys used mixed mode data collection methods.

Comparability with Other Studies

NMES-1 and NMES-2 are the first two in a series of three national medical expenditure studies. The third study is the Medical Expenditure Panel Survey (MEPS) which began in 1996. For information on MEPS, click here.

NMES Data Availability

NMES-1 and NMES-2 data are available from ICPSR. To obtain a listing of available data files search under "National Medical Expenditure Survey" in the ICPSR data archive.

Publications

The Agency for Health Care Policy and Research (AHCPR) maintains a comprehensive list of NMES publications. This list consists of publications published or reprinted by AHCPR. To view the titles of available publications, browse the following subject headings in the AHCPR Publications Catalog:

Children's Health
Data Development and Use
Dental Health
Health Care Cost and Utilization
Health Insurance/Access to Care
Minority Health
Statistical and Methodological Research
Women's Health

NMES publications may be ordered directly from AHCPR. Many of these publications also may be consulted in the NORC Library. Check with the Library's web catalog for NMES holdings.