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<h1 class="page__title title" id="page-title">National Healthcare Quality & National Healthcare Disparities Reports: Measure Specification Appendix, 2013</h1>
<div class="field field-name-field-subtitle field-type-text field-label-hidden"><div class="field-items"><div class="field-item even">Access to Care: Affordability</div></div></div><div class="field field-name-ahrq-generic-body field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p><a id="top" name="top">&nbsp;</a></p>
<h3>Measures</h3>
<p><a href="#cost1">People under age 65 whose family's health insurance premium and out-of-pocket medical expenditures were more than 10% of total family income</a><br />
<a href="#cost2">People under age 65 with private insurance whose family's health insurance premiums and out-of-pocket medical expenditures were more than 10% of total family income</a><br />
<a href="#cost3">People without a usual source of care who indicated a financial or insurance reason for not having a source of care</a><br />
<a href="#cost4">People unable to get or delayed in getting needed medical care, dental care, or prescription medicines due to financial or insurance reasons</a><br />
<a href="#cost5">People who were unable to get or delayed in getting needed medical care due to financial or insurance reasons in the last 12 months</a><br />
<a href="#cost6">People who were unable to get or delayed in getting needed dental care due to financial or insurance reasons in the last 12 months</a><br />
<a href="#cost7">People who were unable to get or delayed in getting needed prescription medications due to financial or insurance reasons in the last 12 months</a><br />
&nbsp;</p>
<hr />
<p><a id="cost1" name="cost1">&nbsp;</a></p>
<h3>Measure Title</h3>
<p>People under age 65 whose family's health insurance premiums and out-of-pocket medical expenditures were more than 10% of total family income</p>
<h3>Measure Source</h3>
<p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)</p>
<h3>Table Description</h3>
<h4>Geographic Representation</h4>
<p>National</p>
<h4>Years Available</h4>
<p>2006-2010</p>
<h4>Population Subgroups</h4>
<p>Activity limitation, age, education, employment status, race/ethnicity, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex</p>
<h3>Data Sources</h3>
<p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)</p>
<h3>Denominator</h3>
<p>U.S. civilian noninstitutionalized population under age 65</p>
<h3>Numerator</h3>
<p>Subset of the denominator whose family's out-of-pocket medical expenditures were more than 10% of total family income</p>
<h3>Comments</h3>
<p>Health insurance premium is determined as the sum of insurance premiums (imputed) and Medicare Part B expenditures. Total family income is the sum of person-level pretax total income, refund income, and sale income. "Family" is defined in terms of health insurance eligibility units (HIEUs), which are composed of individuals who could be covered as a family under most private health insurance plans. For income, insurance, expenditures, and premiums, a family is defined in terms of HIEUs.</p>
<p class="size2"><a href="#top">Top of Page</a></p>
<hr />
<p><a id="cost2" name="cost2">&nbsp;</a></p>
<h3>Measure Title</h3>
<p>People under age 65 with private insurance whose family's health insurance premiums and out-of-pocket medical expenditures were more than 10% of total family income</p>
<h3>Measure Source</h3>
<p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)</p>
<h3>Table Description</h3>
<h4>Geographic Representation</h4>
<p>National</p>
<h4>Years Available</h4>
<p>2006-2010</p>
<h4>Population Subgroups</h4>
<p>Activity limitation, age, education, employment status, race/ethnicity, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex</p>
<h3>Data Sources</h3>
<p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)</p>
<h3>Denominator</h3>
<p>U.S. civilian noninstitutionalized population under age 65 who had private insurance, including employer-sponsored and nongroup coverage</p>
<h3>Numerator</h3>
<p>Subset of the denominator whose family's out-of-pocket medical expenditures were more than 10% of total family income</p>
<h3>Comments</h3>
<p>Total family income was determined as the sum of person-level pretax total income, refund income, and sale income. "Family" is defined in terms of health insurance eligibility units (HIEUs), which are composed of individuals who could be covered as a family under most private health insurance plans. For income, insurance, expenditures, and premiums, a family is defined in terms of HIEUs. Private health insurance includes:</p>
<ul>
<li>Private, employer sponsored: people who had at least 1 month of employer-sponsored insurance and zero months uninsured during the year.</li>
<li>Private, nongroup: people who had least 1 month of nongroup private insurance and zero months uninsured during the year.</li>
</ul>
<p class="size2"><a href="#top">Top of Page</a></p>
<hr />
<p><a id="cost3" name="cost3">&nbsp;</a></p>
<h3>Measure Title</h3>
<p>People without a usual source of care who indicated a financial or insurance reason for not having a source of care</p>
<h3>Measure Source</h3>
<p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)</p>
<h3>Table Description</h3>
<h4>Geographic Representation</h4>
<p>National</p>
<h4>Years Available</h4>
<p>2002-2010</p>
<h4>Population Subgroups</h4>
<p>Activity limitation, age, education, employment status, race/ethnicity, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex, U.S. born</p>
<h3>Data Sources</h3>
<p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)</p>
<h3>Denominator</h3>
<p>U.S. civilian noninstitutionalized population who reported having no usual source of care</p>
<h3>Numerator</h3>
<p>Subset of the denominator who indicated a financial or insurance reason for not having a usual source of care</p>
<p class="size2"><a href="#top">Top of Page</a></p>
<hr />
<p><a id="cost4" name="cost4">&nbsp;</a></p>
<h3>Measure Title</h3>
<p>People unable to get or delayed in getting medical care, dental care, or prescription medications due to financial or insurance reasons</p>
<h3>Measure Source</h3>
<p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)</p>
<h3>Table Description</h3>
<h4>Geographic Representation</h4>
<p>National</p>
<h4>Years Available</h4>
<p>2002-2010</p>
<h4>Population Subgroups</h4>
<p>Activity limitation, age, education, employment status, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex, U.S. born</p>
<h3>Data Sources</h3>
<p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)</p>
<h3>Denominator</h3>
<p>U.S. families who reported having at least one member experience difficulties or delays in obtaining health care</p>
<h3>Numerator</h3>
<p>Subset of the denominator who indicated difficulties or delays in obtaining health care related to: (1) affordability, (2) lack of approval or change by insurance company, (3) inability to get a referral, or (4) expense associated with the site of care.</p>
<h3>Comments</h3>
<p>Race, ethnicity, family income, and education characteristics are those of the family reference person and are used to characterize the entire family unit.</p>
<p class="size2"><a href="#top">Top of Page</a></p>
<hr />
<p><a id="cost5" name="cost5">&nbsp;</a></p>
<h3>Measure Title</h3>
<p>People who were unable to get or delayed in getting needed medical care due to financial or insurance reasons in the last 12 months</p>
<h3>Measure Source</h3>
<p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)</p>
<h3>Table Description</h3>
<h4>Geographic Representation</h4>
<p>National</p>
<h4>Years Available</h4>
<p>2002-2010</p>
<h4>Population Subgroups</h4>
<p>Activity limitation, age, education, employment status, race/ethnicity, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex, U.S. born</p>
<h3>Data Sources</h3>
<p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)</p>
<h3>Denominator</h3>
<p>U.S. families reporting that at least one family member experienced difficulty in obtaining health care, including those with members who attempted but did not receive care or delayed the needed care</p>
<h3>Numerator</h3>
<p>Subset of the denominator reporting each of three reasons causing difficulty in obtaining health care: (1) cost (could not afford), (2) insurance-related reasons, and (3) other reasons in the last 12 months.</p>
<h3>Comments</h3>
<p>This measure is referred to as measure AHS-6.1 in Healthy People 2020 documentation.</p>
<p class="size2"><a href="#top">Top of Page</a></p>
<hr />
<p><a id="cost6" name="cost6">&nbsp;</a></p>
<h3>Measure Title</h3>
<p>People who were unable to get or delayed in getting needed dental care due to financial or insurance reasons in the last 12 months</p>
<h3>Measure Source</h3>
<p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)</p>
<h3>Table Description</h3>
<h4>Geographic Representation</h4>
<p>National</p>
<h4>Years Available</h4>
<p>2002-2010</p>
<h4>Population Subgroups</h4>
<p>Activity limitation, age, education, employment status, race/ethnicity, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex, U.S. born</p>
<h3>Data Sources</h3>
<p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)</p>
<h3>Denominator</h3>
<p>U.S. families reporting that at least one family member experienced difficulty in obtaining health care, including those with members who attempted but did not receive care or delayed the needed care</p>
<h3>Numerator</h3>
<p>Subset of the denominator reporting each of three reasons causing difficulty in obtaining health care: (1) cost (could not afford), (2) insurance-related reasons, and (3) other reasons in the last 12 months.</p>
<h3>Comments</h3>
<p>This measure is referred to as measure AHS-6.1 in Healthy People 2020 documentation.</p>
<p class="size2"><a href="#top">Top of Page</a></p>
<hr />
<p><a id="cost7" name="cost7">&nbsp;</a></p>
<h3>Measure Title</h3>
<p>People who were unable to get or delayed in getting needed prescription medications due to financial or insurance reasons in the last 12 months</p>
<h3>Measure Source</h3>
<p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)</p>
<h3>Table Description</h3>
<h4>Geographic Representation</h4>
<p>National</p>
<h4>Years Available</h4>
<p>2002-2010</p>
<h4>Population Subgroups</h4>
<p>Activity limitation, age, education, employment status, race/ethnicity, geographic location (residence), income, insurance, perceived health status, preferred language, race/ethnicity, sex, U.S. born</p>
<h3>Data Sources</h3>
<p>Agency for Healthcare Research and Quality (AHRQ), Center for Financing, Access, and Cost Trends (CFACT), Medical Expenditure Panel Survey (MEPS)</p>
<h3>Denominator</h3>
<p>U.S. families reporting that at least one family member experienced difficulty in obtaining health care, including those with members who attempted but did not receive care or delayed the needed care</p>
<h3>Numerator</h3>
<p>Subset of the denominator reporting each of three reasons causing difficulty in obtaining health care: (1) cost (could not afford), (2) insurance-related reasons, and (3) other reasons in the last 12 months.</p>
<h3>Comments</h3>
<p>This measure is referred to as measure AHS-6.1 in Healthy People 2020 documentation.</p>
<p class="size2"><a href="#top">Top of Page</a></p>
<p class="size2"><a href="/research/findings/nhqrdr/nhqrdr13/measurespec/index.html">Return to Contents</a><br />
<a href="/research/findings/nhqrdr/nhqrdr13/measurespec/access-source.html">Proceed to Next Section</a></p>
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Page last reviewed <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2014-07-01T00:00:00-04:00">July 2014</span> <br />Page originally created July 2014 </div>
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<div id="block-ahrq-citation" class="block block-ahrq first odd">
Internet Citation: National Healthcare Quality & National Healthcare Disparities Reports: Measure Specification Appendix, 2013. Content last reviewed July 2014. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/research/findings/nhqrdr/nhqrdr13/measurespec/access-affordability.html<div class="citation-flag"></div>
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