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Using State Health Compare to Analyze Estimates of Health Care Access, Cost, and Utilization

State Health Compare is a new, user-friendly online tool from SHADAC for obtaining and comparing state-level estimates related to health and health care. 

This post provides an overview of the state estimates available through State Health Compare for indicators of health care access, affordability and utilization. These indicators, which come from the National Health Interview Survey (NHIS), are available at the state level exclusively through State Health Compare.

Where sample size permits, estimates for the following measures are broken down by age (0–18, 0–64, 19–64, 65+) and coverage type (uninsured, public coverage, private coverage):

• Access to Care Measures
  No Trouble Finding Doctor
  Told That Provider Accepts Insurance
  Had Usual Source of Medical Care

• Cost of Care Measures
  Made Changes to Medical Drugs
  Trouble Paying Medical Bills
  Needed but Delayed Medical Care
  Needed but Did Not Get Medical Care

• Utilization of Care Measures
  Had General Doctor or Provider Visit
  Had Emergency Department Visit
  Spent the Night in a Hospital
   

Leveraging State Health Compare to Analyze NHIS Indicators

The following examples use the measure ‘Spent the Night in a Hospital’ to show how analysts can use the data and tools provided by State Health Compare to analyze these NHIS indicators to better understand trends in health and healthcare at the national and state levels. 

Trend Analyses

State Health Compare allows analysts to examine trends over time while comparing up to seven states at once. Looking at the five year national trend, the share of Americans who reported spending the night in a hospital in the past year has declined, though not substantially, standing at 7.9 percent as of 2015, compared to 8.4 percent in 2011.

Geographic Variation

In addition to national and state averages over time, State Health Compare allows analysts to explore the substantial geographic variation using maps and ranked bar charts. As shown in the map below, on the high end, states as diverse as Hawaii, Oklahoma, North Dakota, Tennessee, Kentucky, Ohio, Rhode Island, Massachusetts, and New Hampshire all had rates of overnight hospitalization between 9.8 percent and 12.4 percent in 2015. On the low end, Washington, California, Nevada, Colorado, Texas, Arkansas, Delaware, Vermont, and Maine all had rates between 4.8 percent and 6.7 percent in 2015.

Demographic Breakdowns

State Health Compare also allows analysts to see how rates of hospitalization and other indicators differ by age or by coverage type at the national and state level (where sample sizes permit). The bar graph below compares rates of hospitalization in 2015 in the U.S., California, and Kentucky broken down by age group. In all three locations, a larger share of individuals 65 years and older report spending a night in the hospital compared with non-elderly populations. Kentucky’s rates of hospitalization among all groups is higher than rates in California or nationally.

State Health Compare also gives analysts the ability to see how rates of hospitalization have changed over time at the national and state level by age or by coverage type. The chart below shows how national rates of hospitalization have changed from 2011 to 2015 by coverage type. The hospitalization rate among those with public coverage was consistently higher than those with private coverage or those who were uninsured. This difference is likely due to the greater rates of hospitalization among elderly Americans (as shown above), most of whom have public Medicare coverage and who make up a large portion of the public coverage group.

As shown, rates of hospitalization have been going down among all three coverage types, though the decline has been the largest for those with public coverage (1.2 percentage-point decline from 2011 to 2015). Hospitalization declined among the uninsured after peaking in 2012, dropping to 4.5 percent in 2015. Rates of hospitalization have remained somewhat steadier among those with private coverage, dropping only 0.6 percentage points between 2011 and 2015.

REMINDER: Virtual Tour of State Health Compare on May 23^rd

Learn more about State Health Compare during a virtual tour on Tuesday, May 23rd, at 12:00 p.m. Central. SHADAC Senior Research Fellow Joanna Turner will lead the tour and answer questions from attendees. Ms. Turner will be joined by Carolyn Miller, Senior Program Officer at the Robert Wood Johnson Foundation, and by SHADAC Director Lynn Blewett.

Register for this event.