State Health Access Data Assistance Center, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, USA.
Am J Public Health. 2010 Oct;100(10):1972-9. doi: 10.2105/AJPH.2009.167247. Epub 2010 Aug 19.
We examined whether 3 nationally representative data sources produce consistent estimates of disparities and rates of uninsurance among the American Indian/Alaska Native (AIAN) population and to demonstrate how choice of data source impacts study conclusions.
We estimated all-year and point-in-time uninsurance rates for AIANs and non-Hispanic Whites younger than 65 years using 3 surveys: Current Population Survey (CPS), National Health Interview Survey (NHIS), and Medical Expenditure Panel Survey (MEPS).
Sociodemographic differences across surveys suggest that national samples produce differing estimates of the AIAN population. AIAN all-year uninsurance rates varied across surveys (3%-23% for children and 18%-35% for adults). Measures of disparity also differed by survey. For all-year uninsurance, the unadjusted rate for AIAN children was 2.9 times higher than the rate for White children with the CPS, but there were no significant disparities with the NHIS or MEPS. Compared with White adults, AIAN adults had unadjusted rate ratios of 2.5 with the CPS and 2.2 with the NHIS or MEPS.
Different data sources produce substantially different estimates for the same population. Consequently, conclusions about health care disparities may be influenced by the data source used.
我们考察了 3 个具有全国代表性的数据源在评估美国印第安人/阿拉斯加原住民（AIAN）人群的差异和保险覆盖率方面是否产生一致的估计，并展示了数据源的选择如何影响研究结论。
我们使用 3 项调查（当前人口调查（CPS）、国家健康访谈调查（NHIS）和医疗支出面板调查（MEPS））来估计所有年龄段和特定时间点的 AIAN 和 65 岁以下非西班牙裔白人的未保险率。
调查之间的社会人口统计学差异表明，全国性样本对 AIAN 人群的估计存在差异。AIAN 的全年未保险率因调查而异（儿童为 3%-23%，成人则为 18%-35%）。差异衡量指标也因调查而异。对于全年未保险，AIAN 儿童的未调整比率比 CPS 中白人儿童的比率高 2.9 倍，但与 NHIS 或 MEPS 相比，没有显著的差异。与白人成年人相比，AIAN 成年人在 CPS 中的未调整率比值为 2.5，在 NHIS 或 MEPS 中的未调整率比值为 2.2。
相同的人群使用不同的数据来源会产生截然不同的估计。因此，关于医疗保健差异的结论可能会受到所使用的数据来源的影响。
