This report presents health service utilization rates by economic and demographic characteristics, health insurance coverage status, and health status.1 The health service utilization rates are measured by the frequencies of visits to service providers, such as doctors, dentists, and hospitals, and by whether or not people are taking prescription medicine. Self-reported health status is measured on a scale ranging from 1 to 5, where 1 is “excellent” and 5 is “poor.”
While a majority of people have private health insurance, employment-based or self-purchased, and others have government-provided free health insurance, some remain without health insurance.2 According to the Annual Social an Economic Supplement (ASEC) to the Current Population Survey (CPS), 60.4 percent of people in 2003 had employment-based health insurance, 26.6 percent had government health insurance, and 15.6 percent were without health insurance for the entire year.3
According to the Survey of Income and Program Participation’s (SIPP) 1996 panel, 8.3 percent of people were without health insurance coverage for the entire 1997 calendar year.4 Another 13.3 percent of people were covered during some part of 1997, but they lacked coverage for at least 1 month.5 Among the 98 million people who worked for an employer offering health insurance to their employees, 13 million eligible workers chose not to participate in their employers’ plans in 1997; 3 million cited cost as one of the reasons, and 10 million had coverage through another source.6 Others were denied or were ineligible for health insurance coverage.7
This report uses data from the SIPP 2001 panel, Wave 3, administered between October 2001 and January 2002.8 While most data are contained in the topical module on medical expenses and utilization, information on demographic characteristics and health insurance coverage come from the core data.9 In the SIPP core survey, respondents provide monthly information about their health insurance status as well as other information for a 4-month period.10 In this topical module, respondents provide information for all 12 months prior to the interview. For more information on the SIPP, see the text box “The SIPP—A Longitudinal Survey.”
1 The data presented in this report were collected from October 2001 through January 2002 in the third wave of the 2001 Survey of Income and Program Participation. The population presented is the civilian noninstitutionalized population living in the United States. All comparisons made in this report have undergone statistical testing and are significant at the 90-percent confidence level unless therwise noted.
2 An employer offering health insurance may be the respondent’s own employer or another person’s employer.
3 DeNavas-Walt, Carmen, Bernadette Proctor, and Robert Mills (2004), Income, Poverty, and Health Insurance Coverage in the United States: 2003, U.S. Census Bureau: <www.census.gov/prod2004pubs/p60-226.pdf>.
4 The CPS estimate of uninsured for 1997 was 16.1 percent. The variation between the SIPP and CPS estimates is due to differences in the survey techniques used by the two surveys.
5 Bhandari, Shailesh and Robert Mills (2003), Dynamics of Economic Well-Being: Health Insurance 1996-1999, U.S. Census Bureau: <www.census.gov/prod/2003pubs/p70-92.pdf>.
6 Respondents could cite several reasons for choosing no coverage. Therefore, the two groups are not mutually exclusive.
7 Bhandari, Shailesh (2002), Employment-Based Health Insurance: 1997, U.S. Census Bureau: <www.census.gov/prod/2003pubs/p70-81.pdf>.
8 For the 2001 SIPP Panel, approximately 40,500 housing units were in sample fo Wave 1. Of the 40,500 eligible units, 35,100 were interviewed. In Wave 2, an approximate 15 percent sample cut was implemented due to budget constraints. In Wave 2, 28,100 interviews were obtained from 30,500 eligible units. In Wave 3, 27,500 interviews were obtained from 30,900 eligible units. In Wave 4, 27,200 interviews were obtained from 31,100 eligible units. In Wave 5, 26,800 interviews were obtained from 31,300 eligible units. In Wave 6, 26,600 interviews were obtained from 31,400 eligible units. In Wave 7, 26,500 interviews were obtained from 31,500 eligible units. In Wave 8, 26,000 interviews were obtained from 31,600 eligible units. In Wave 9, 25,500 interviews were obtained from 31,700 eligible units.
9 The same topical module was administered in Waves 6 and 9.
10 Although SIPP is essentially a survey designed to measure the social and economic characteristics of low-income households, its large sample size makes it a reliable data source for medical expense and service utilization analysis. A brief comparison of SIPP with the Medical Expenditure Panel Survey is presented in the appendix.