Primary Care Audit Study for 10 States in the United States, 2012-2013, 2014 & 2016 (ICPSR 36785)

Version Date: Oct 10, 2018

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Principal Investigator(s):
Daniel Polsky, University of Pennsylvania; Karin Rhodes, Northwell Health

https://doi.org/10.3886/ICPSR36785.v1

Version V1

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Summary

Coverage expansion under the Affordable Care Act (ACA) has important implications for access, and the value of coverage is dependent on the ability to access care. Most information about access to care comes from household or physician surveys.

The current data collection was gathered as a part of the Primary Care Audit Study for 10 States in the United States, 2012-2013, 2014 and 2016 to assess variation in access to primary care using a methodology that was applied across different types of states (Arkansas, Georgia, Illinois, Iowa, Massachusetts, Montana, New Jersey, Oregon, Pennsylvania, and Texas) at baseline and over-time. The project was broken up into three phases: before the ACA (2012-2013), during the launch of ACA coverage provisions such as the Medicaid fee bump and ACA marketplaces (2014), and after the full ACA implementation (2016). Insurance types in the study included commercial coverage, Medicaid, uninsured, and, in 2014 and 2016, plans purchased on the ACA market place.

The audit-level file, featured in part one of the collection, includes all completed calls and provides information from multiple dimensions (appointment availability, wait times, simulated patients' demographics, cost information, etc.).

The office-level file, featured in part two of the collection, covers all eligible offices and their characteristics (e.g., size, insurance acceptability, cost information, etc.) collected from the screening phase.

Demographic variables include simulated caller number, race, gender, and age.

Citation

Polsky, Daniel, and Rhodes, Karin. Primary Care Audit Study for 10 States in the United States, 2012-2013, 2014 & 2016. Inter-university Consortium for Political and Social Research [distributor], 2018-10-10. https://doi.org/10.3886/ICPSR36785.v1

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Funding

Robert Wood Johnson Foundation (70160)

Subject Terms

Geographic Coverage

Smallest Geographic Unit

county

Distributor(s)

Inter-university Consortium for Political and Social Research
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Time Period(s)

2012 -- 2013 (Wave 1), 2014 (Wave 2), 2016 (Wave 3)

Date of Collection

2012-11 -- 2013-03 (Wave 1), 2014-05 -- 2014-07 (Wave 2), 2016-02 -- 2016-06 (Wave 3)
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Study Purpose

The study's purpose was to assess variation in access to primary care using a methodology that simulated patient experiences and could be used to track access over time.

Study Design

The study used audit methodology (phone calls to medical offices from simulated consumers) to measure access to care under a variety of scenarios. The experiences of trained field staff posing as new patients seeking primary care appointments were tracked. This methodology was applied across 10 selected states in the United States (Arkansas, Georgia, Illinois, Iowa, Massachusetts, Montana, New Jersey, Oregon, Pennsylvania, and Texas).

Trained field staff were randomly assigned to an insurance type and a script requesting the earliest appointment with a specified primary care physician (PCP) or any other available provider. An appointment was defined as available if the caller was offered a specific date and time.

Simulated audit calls were conducted in three time periods/waves: from November 2012 through March 2013, from May 2014 through July 2014, and from February 2016 through June 2016.

Sample

Primary care offices were sampled using the SK and A Office-Based Physician Database. The sampled offices needed at least one primary care physician (PCP) who treated adults and participated in at least one of the plans in the relevant insurance type.

A pre-audit screening was performed to collect office-level characteristics and to remove unqualified offices (e.g., closed, out of scope, unreachable, etc.). Some offices were later removed from the sample frame during the audit phase because of ineligibility.

Offices were randomly selected within county, insurance type, and time period according to the population's insurance type distribution.

In total, 11,192 unique primary care offices were selected as the final office cohort.

Completed calls totaled 12,919 during the first period, 12,848 during the second period, and 14,857 during the third period.

Time Method

Cross-sectional

Universe

Primary care offices (call centers) with at least one primary care physician (PCP) in 10 states (Arkansas, Georgia, Illinois, Iowa, Massachusetts, Montana, New Jersey, Oregon, Pennsylvania, and Texas) during three time periods: November 2012 through March 2013, May 2014 through July 2014, and February 2016 through June 2016.

Unit(s) of Observation

Individual Practice, Individual Patient

Data Type(s)

Mode of Data Collection

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Original Release Date

2018-10-10

Version History

2018-10-10 ICPSR data undergo a confidentiality review and are altered when necessary to limit the risk of disclosure. ICPSR also routinely creates ready-to-go data files along with setups in the major statistical software formats as well as standard codebooks to accompany the data. In addition to these procedures, ICPSR performed the following processing steps for this data collection:

  • Created online analysis version with question text.
  • Checked for undocumented or out-of-range codes.
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Weight

The study includes the following weight variables that should be used in analysis:

  • WTN
  • G
  • PPOP_G

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Notes

  • The public-use data files in this collection are available for access by the general public. Access does not require affiliation with an ICPSR member institution.