The Effects of Trigger Events on Changes in Children's Health Insurance Coverage. 3. Response Error

04/18/2000

We also considered the possibility that the frequent reversals of transitions between one SIPP interview and the next could reflect error in the reporting of health insurance coverage. Specifically, if coverage during a reference period were misreported and then corrected in the next, this would give the appearance of an initial transition followed by a reversal. One way in which such error could occur is through changes in the respondent. While the intent in the SIPP is that each adult respondent answer his or her own questions, nearly a quarter of all SIPP interviews are conducted with proxies--that is, someone in the household other than the intended respondent answers the questions for that respondent. 12 A change in respondent from self to proxy occurring between one wave and the next could result in the respondent's health insurance coverage being misreported for that reference period. If the respondent returned to answer the questions in the next wave, the earlier, correct coverage could be reported again, giving the appearance of a reversal of the "transition" recorded during the previous wave.

To assess whether changes in respondent may account for a disproportionate number of reported transitions and, in particular, transitions that were reversed by the next interview, we examined the frequency with which transitions coincided with changes in respondent for the father, mother, or child 15 and older. For all children, even those 15 and older, we identified changes in the proxy status of each parent. For children 15 and older we also identified changes in their own respondent status. Any of these respondents--or their proxies--could have been responsible for reporting a child's health insurance coverage.

Our findings, presented in Table 4, indicate very clearly that we can reject the possibility that the frequent reversals of transitions between one SIPP interview and the next can be explained by changes between self- and proxy respondent. The frequency with which transitions were reported and the frequency with which they were reversed were no more common among children with changes in respondent than among children with the same respondent over the interviews in question. In all, 28.5 percent of the estimated 23 million transitions coincided with changes in respondent, and 16.5 percent coincided with changes in respondent that were reversed at the next interview. Of the estimated 9.4 million transitions that were followed within four months by second transitions, 28.0 percent were accompanied by changes in respondent and 14.6 percent by changes in respondent that were reversed. Clearly, then, respondent changes were no more common among transitions that were followed by second transitions than they were among all transitions. Likewise, of the 7.6 million transitions that were reversed within four months, 26.1 percent coincided with changes in respondent and 13.2 percent coincided with respondent changes that were themselves reversed at the next interview. Again, these respondent changes were no more frequent among transitions that were reversed in four months than they were among all transitions.

We will review additional but more indirect evidence relating to response error in Section E.

Type of Transition Annual
Number
of
Transitions
Percent
with a
Change in
Respondent
Percent
with a
Change in
Respondent
Reversed
Number
Followed
by a
Second
Transition
Percent
with a
Change in
Respondent
Percent
with a
Change in
Respondent
Revealed
Number
of Initial
Transitions
Reversed
Percent
with a
Change in
Respondent
Percent
with a
Change in
Respondent
Reversed
TABLE 4: FREQUENCY WITH WHICH CHANGES IN RESPONDENT COINCIDED
WITH REPORTED TRANSITIONS IN CHILDREN'S HEALTH INSURANCE COVERAGE
 
Total Number of Transitions 23,325,000 28.5 16.5 9,411,000 28.0 14.6 7,593,000 26.1 13.2
 
Transitions from ESI to: 7,178,000 29.9 17.2 3,888,000 29.3 15.1 3,268,000 27.0 14.1
   Uninsured 3,619,000 29.4 16.4 1,821,000 29.9 14.7 1,455,000 28.7 13.2
   Medicaid 1,720,000 32.7 18.9 1,107,000 29.8 15.1 938,000 24.7 14.1
   Other Insurance 1,840,000 28.2 17.2 960,000 27.4 15.8 875,000 26.7 15.8
 
Transitions from Uninsured to: 7,830,000 28.4 17.6 2,561,000 28.7 16.2 2,055,000 26.6 15.3
   ESI 3,546,000 32 19.7 864,000 30.9 16.5 660,000 28.5 16.2
   Medicaid 3,640,000 25.6 17.0 1,384,000 25 16.1 1,214,000 21.6 14.0
   Other Insurance 645,000 24.6 9.5 314,000 38.8 15.6 182,000 52.6 20.5
 
Transitions from Medicaid to: 5,879,000 25.9 12.3 2,230,000 26.7 11.9 1,656,000 24.6 8.2
   Uninsured 3,872,000 25.5 11.0 1,700,000 23.9 10.2 1,337,000 22.6 7.8
   ESI 1,798,000 26 13.8 406,000 33.6 13.9 283,000 33.3 11.5
   Other Insurance 209,000 33.1 24.6 124,000 42.7 28.5 37,000 31.2 0.0
 
Transitions from Other Insurance to: 2,438,000 30.9 20.7 732,000 23.2 15.3 614,000 24.0 14.5
   ESI 1,777,000 42.4 28.4 433,000 39.2 25.8 401,000 36.7 22.2
   Uninsured 547,000 97.3 62.6 253,000 30.3 23.9 195,000 36.4 28.1
   Medicaid 113,000 16.4 16.4 45,000 15.4 15.4 18,000 0.0 0.0
 
SOURCE: Survey of Income and Program Participation, 1992 Panel.

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