Community Tracking Study Series

collection: series

Investigator(s): Center for Studying Health System Change

Studies

2

Variables

1,925

Publications

177

About this Collection

The Community Tracking Study (CTS), a project of the Center for Studying Health System Change (HSC), is a large-scale longitudinal investigation of health system change and its effects on people. Designed to track a cohort of American communities at two-year intervals beginning in 1996, this major research effort, sponsored by The Robert Wood Johnson Foundation (RWJF), gathers information to monitor and understand the evolution of health care in the United States. CTS is investigating the ways in which hospitals, health plans, physicians, safety-net providers, and other provider groups are restructuring their systems, and the forces driving the organizational changes. Additionally, the project tracks health insurance coverage, access to care, use of health services, health care costs, and perceived quality of health care. Sixty sites (51 metropolitan areas and 9 nonmetropolitan areas) were randomly selected to form the core of CTS and to be representative of the nation as a whole. Much of the information collected by CTS comes from nationally representative surveys of households, health plans, and physicians conducted by HSC. The Household Survey is administered to households in the 60 CTS sites, plus a supplemental national sample of households, covering some 60,000 individuals. A survey of health plans, the Followback Survey, elicits detailed information on private health insurance coverage reported in the Household Survey from organizations that offer or administer private health insurance policies in the CTS sites. The Physician Survey interviews physicians in the 60 CTS sites and a supplemental national sample of physicians. RWJF has built a network of research organizations that are studying various facets of the changing health care system, some of which are simultaneously examining the CTS communities. Stephen H. Long and M. Susan Marquis at RAND conducted an employer survey (Robert Wood Johnson Foundation Employer Health Insurance Survey [Community Tracking Study and State Initiatives in Health Care Reform Program], 1997) with a special emphasis on the 60 CTS sites. At UCLA and RAND, Kenneth B. Wells, Audrey Burman, and Roland Sturm are examining how public policies and markets are affecting access to substance abuse and mental health services. Their survey, National Survey of Alcohol, Drug, and Mental Health Problems [Healthcare for Communities], 1997-1998, reinterviewed some 9,600 respondents from the CTS Household Survey about their health and daily activities, use of alcohol, illicit drugs, and medications, health insurance coverage and coverage for mental health, plus access to, utilization, and quality of behavioral health care.

Studies

2 results
Partially restricted

Community Tracking Study Household Survey, 1998-1999, and Followback Survey, 1998-2000: [United States]

This collection comprises the second round of the Community Tracking Study (CTS) Household Survey and the second round of the CTS Followback Survey. The CTS, sponsored by the Robert Wood Johnson Foundation, is a national study designed to track changes in the health care system and their effects on care delivery and individuals. Fifty-one metropolitan areas and nine nonmetropolitan areas were randomly selected to form the core of the CTS and to be representative of the nation as a whole. As in the first round of the Household Survey (COMMUNITY TRACKING STUDY HOUSEHOLD SURVEY, 1996-1997, AND FOLLOWBACK SURVEY, 1997-1998: [UNITED STATES] (ICPSR 2524)), the second round of the Household Survey was administered to households in the 60 CTS sites and to a supplemental national sample of households. Respondents provided information about household composition and demographic characteristics, health insurance coverage, use of health services, unmet health care needs, out-of-pocket expenses for health care, usual source of care, patient trust and satisfaction, last visit to a medical provider, health status and presence of chronic health conditions, risk behaviors and smoking, and employment, earnings, and income. The purpose of the Followback Survey was to obtain detailed information on private health insurance coverage reported in the Household Survey. It was administered to the health plans and other organizations (managed care organizations, third-party administrators, employer or union plans, and employers) that offered or administered the respondents' comprehensive private health insurance policies. Information on private health insurance policies collected by the Followback Survey includes product type, gatekeeping, consumer cost sharing, provider payment methods, and coverage of mental health and/or substance abuse services.
Partially restricted

Health Tracking Household Survey, 2007 [United States]

The 2007 Health Tracking Household Survey (HTHS) is the successor to the Community Tracking Study (CTS) Household Surveys which were conducted in 1996-1997 (ICPSR 2524), 1998-1999 (ICPSR 3199), 2000-2001 (ICPSR 3764), and 2003 (ICPSR 4216). Although the HTHS questionnaires are similar to the CTS Household Survey questionnaires, the HTHS sampling design does not have the community focus intrinsic to CTS. Whereas the CTS design focused on 60 nationally representative communities with sample sizes large enough to draw conclusions about health system change in 12 communities, the HTHS design is a national sample not aimed at measuring change within communities. Hence, "Community" was dropped from the study title. Like the CTS Household Surveys, HTHS collected information on health insurance coverage, use of health services, health expenses, satisfaction with health care and physician choice, unmet health care needs, usual source of care and patient trust, health status, adult chronic conditions, height and weight, and smoking behavior. In addition, the survey inquired about perceptions of care delivery and quality, problems with paying medical bills, use of in-store retail and onsite workplace health clinics, patient engagement with health care, sources of health information, and shopping for health care.

At the beginning of the interview, a household informant provided information about the composition of the household which was used to group the household members into family insurance units (FIU). Each FIU comprised an adult household member, his or her spouse or domestic partner (same sex and other unmarried partners), if any, and any dependent children 0-17 years of age or 18-22 years of age if a full-time student (even if living outside the household). In each FIU in the household, a FIU informant provided information on insurance coverage, health care use, usual source of care, and general health status of all FIU members. This informant also provided information on family income as well as employment, earnings, employer-offered insurance plans, and race/ethnicity for all adult FIU members. Moreover, every adult in each FIU (including the FIU informant) responded through a self-response module to questions that could not be answered reliably by proxy respondents, such as questions about unmet needs, assessments of the quality of care, consumer engagement, satisfaction with physician choice, use of health information, health care shopping, and detailed health questions. The FIU informants responded on behalf of children regarding unmet needs, satisfaction with physician choice, and use of health care information.