Agency for Healthcare 

Medical Expenditure Panel Survey Research and Quality 

STATISTICAL BRIEF #82 

June 2005 

Access to Care and Use of Preventive 

Services, 2002: Estimates for the U.S. 

Civilian Noninstitutionalized Population, 

Age 18 to 64 

Jeffrey A. Rhoades, PhD 

Introduction 

This Statistical Brief examines the relationship between health 

insurance coverage status in 2002 and access to care and the use of 

health care, including preventive services, among individuals 

between the ages of 18 to 64 in the U.S. civilian noninstitutionalized 

population in 2002. Comparisons are made between men and 

women. Only differences between estimates that are statistically 

significant at the 0.05 level are discussed in the text. 

Findings 

In 2002, men age 18 to 64 were more likely to be uninsured in 

comparison to women: 17.8 percent of men were uninsured while 

13.6 percent of women were uninsured. The majority of men and 

women had private health insurance, at 75.8 percent and 76.1 

percent, respectively; and 6.4 percent of men and 10.3 percent of 

women were covered by only public health insurance. (figure 1) 

Based on health insurance status, uninsured women and men age 

18 to 64 were the most likely to lack a usual source of care in 2002, 

at 42.2 percent and 60.3 percent, respectively. For those with only 

public health insurance, 20.1 percent of women and 22.6 percent of 

men lacked a usual source of care. Women age 18 to 64 who had 

private health insurance were the least likely to lack a usual source 

of care (15.3 percent). (figure 2) 

Individuals age 18 to 64 with only public health insurance had a 

higher mean expense for health care than those with private or no 

health insurance in 2002. Women with only public health insurance 

had a mean expense of $5,316 while men with only public health 

insurance had a mean health care expense of $6,048. The uninsured 

had the lowest mean expense for health care. Uninsured women had 

a mean expense for health care of $1,241; uninsured men had a 

mean expense of $659. The mean expense for health care for 

women and men with private health insurance was $3,042 and 

$2,082, respectively. (figure 3) 

Highlights 

� Men age 18 to 64 were more 

likely to be uninsured than 

women in 2002 (17.8 percent 

versus 13.6 percent). 

� Uninsured individuals age 18 to 

64 were the most likely to lack a 

usual source of care (women 

42.2 percent and men 60.3 

percent). 

� Individuals age 18 to 64 with 

only public health insurance had 

a higher mean expense for 

health care than those with 

private or no health insurance 

(women $5,316 and men 

$6,048). 

� Individuals age 18 to 64 with fair 

or poor health status had the 

highest mean expense for 

health care (women $7,505 and 

men $7,341). 

� Women age 40 to 64 with 

private health insurance were 

more likely (77.2 percent) to 

obtain mammography screening 

within the last two years than 

women with only public or no 

health insurance. 

� Women age 18 to 64 with 

private health insurance were 

more likely (87.0 percent) to 

obtain a Pap test within the last 

three years than women with 

only public or no health insurance. 

� Men age 50 to 64 with private 

health insurance were more 

likely (58.7 percent) to obtain a 

prostate-specific antigen (PSA) 

test within the last two years 

than men with only public or no 

health insurance. 
Based on health status, individuals age 18 to 64 with fair or poor health status had the highest mean 

expense for health care in 2002, at $7,505 for women and $7,341 for men. Men had a lower mean health 

care expense for excellent ($915), very good ($1,424), and good ($2,274) health status than women 

($1,654, $2,256, and $3,225, respectively). (figure 4) 

Women age 40 to 64 covered by private health insurance were more likely to obtain mammography 

screening, 59.5 percent within the last year and 77.2 percent within the last two years, than women with 

only public or no health insurance. Women with no health insurance coverage were the least likely to 

have mammography screening. In 2002, 31.5 percent of uninsured women had mammography screening 

within the last year while 44.5 percent had such within the last two years. Among women with only public 

health insurance, 48.2 percent had mammography screening within the last year and 63.7 percent within 

the last two years. (figure 5) 

The percentage of women obtaining a Pap test varied by health insurance status in 2002. Women age 18 

to 64 with only public health insurance or those who were uninsured were less likely to have received a 

Pap test than women with private health insurance. Within the last year and last three years, 65.9 percent 

and 87.0 percent, respectively, of privately insured women obtained a Pap test. Uninsured women were 

the least likely to obtain a Pap test, 44.6 percent within the last year and 70.8 percent within the last three 

years. For women with only public health insurance, 57.5 percent obtained a Pap test within the last year 

and 78.4 percent within the past three years. (figure 6) 

Men age 50 to 64 covered by private health insurance were more likely to obtain a prostate-specific 

antigen (PSA) test, 45.5 percent within in the last year and 58.7 percent within the last two years than 

men with only public or no health insurance. In comparison, men with no health insurance coverage were 

the least likely to have a PSA test. In 2002, only 22.2 percent of uninsured men had a PSA test within the 

last year, and 28.5 percent had such within the last two years. Among men with only public health 

insurance, 33.9 percent had a PSA test within the last year and 45.4 percent within the last two years. 

(figure 7) 

Data Source 

The estimates shown in this Statistical Brief are drawn from analyses conducted by MEPS staff from the 

2002 Full Year Consolidated Data File, HC-070, which is available on the MEPS Web site, http://www. 

meps.ahrq.gov/. 

Definitions 

Health insurance status 

– Private coverage: Private health insurance coverage was defined as nonpublic insurance that provided 

coverage for hospital and physician care (including TRICARE and Medigap coverage). 

– Public only coverage: People were considered to have only public health insurance coverage if they 

were not covered by private insurance, and they were covered by Medicare, Medicaid, or other public 

hospital and physician coverage. 

– Uninsured: People who did not have insurance coverage at any time during the survey year were 

classified as uninsured. People who were covered only by noncomprehensive State-specific programs 

(e.g., Maryland Kidney Disease Program) or private single service plans (e.g., coverage for dental or 

vision care only, coverage for accidents or specific diseases) were considered to be uninsured. 

Usual source of care 

For each family member, the MEPS interviewer ascertained whether there was a particular doctor’s office, 

clinic, health center, or other place that the individual usually went when sick or in need of health advice. 

For those family members who did not have a usual source of health care, the interviewer ascertained the 

reasons why, but that information is not used in this analysis. 

Expenditures 

Expenditures in MEPS are defined as the sum of direct payments for care provided during the year, 

including out-of-pocket payments and payments by private insurance, Medicaid, Medicare, and other 

sources. Payments for over-the-counter drugs and for alternative care services are not included in MEPS 

total expenditures. Indirect payments not related to specific medical events, such as Medicaid 

Disproportionate Share and Medicare Direct Medical Education subsidies, are also not included. 
Preventive services 

Data on preventive services are based on a series of questions asked in rounds 3 and 5 about preventive 

health care use and when it occurred: within the past year, the past two years, the past three years, the 

past five years, or never. The set of indicators included receipt of mammogram screening, Pap test, 

breast exam, PSA test, physical exam, blood pressure reading, and flu shot. Mammogram screening, Pap 

test, and PSA test were included in this analysis. 

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 

demographic, and economic characteristics for the civilian noninstitutionalized population. It is 

cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health 

Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

References 

For a detailed description of the MEPS-HC survey design, sample design, and methods used to minimize 

sources on nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care, 

July 2003: 41(7) Supplement: III-5–III-12. 

AHRQ produces and distributes resources to encourage appropriate use of preventive care services. 

Consumers may find the following AHRQ guides useful: Men: Stay Healthy at Any Age (http://www.ahrq. 

gov/ppip/healthymen.htm) and Women: Stay Healthy at Any Age (http://www.ahrq.gov/ppip/healthywom. 

htm).

Physicians and health care organizations may wish more information on the U.S. Preventive Services 

Task Force (http://www.ahrq.gov/clinic/uspstfix.htm) or on AHRQ’s tools for putting prevention into 

practice (http://www.ahrq.gov/clinic/ppipix.htm).

Suggested Citation 

Rhoades, J. A. Access to Care and Use of Preventive Services, 2002: Estimates for the U.S. Civilian 

Noninstitutionalized Population, Age 18 to 64. Statistical Brief #82. June 2005. Agency for Healthcare 

Research and Quality, Rockville, Md. http://www.meps.ahrq.gov/papers/st82/stat82.pdf 
Figure 1. Health insurance status of the U.S. civilian 

noninstitutionalized population, age 18 to 64, 2002 

Percent 

17.8 

76.1 

10.3 

13.6 

6.4 

75.8 

0 

20 

40 

60 

80 

Any private Public only Uninsured 

Women Men 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

HC-070, 2002 

Figure 2. Individuals age 18 to 64 with no usual source 

Percent 

23.2 22.6 

42.2 

20.1 

15.3 

19.5 

60.3 

29.8 

0 

25 

50 

75 

Overall Any private Public only Uninsured 

Women Men 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

HC-070, 2002 

of care, by health insurance status, 2002 
Figure 3. Individuals age 18 to 64, mean expenditures 

for health care, by health insurance status, 2002 

659 

5,316 

3,042 

6,048 

2,082 

0 

2,500 

5,000 

7,500 

Overall Any private Public only Uninsured 

Mean health care expenses for women 

Mean health care expenses for men 

Dollars 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

HC-070, 2002 

1,241 

3,032 

2,082 

Figure 4. Individuals age 18 to 64, mean expenditures 

for health care, by health status, 2002 

7,341 

2,256 

1,654 

2,274 

915 

1,424 

0 

2,500 

5,000 

7,500 

Excellent Very good Good Fair/Poor 

Mean health care expenses for women 

Mean health care expenses for men 

Dollars 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

HC-070, 2002 

7,505 

3,225 
Figure 5. Women age 40 to 64 who received 

mammogram screening at recommended intervals, 

by health insurance status, 2002 

44.5 

31.5 

48.2 

59.5 55.3 

63.7 

72.3 

77.2 

0 

25 

50 

75 

100 

Overall Any private Public only Uninsured 

Percent with mammogram within the last year 

Percent with mammogram within the last 2 years 

Percent 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

HC-070, 2002 

Figure 6. Women age 18 to 64 who received 

health insurance status, 2002 

78.4 

70.8 

44.6 

57.5 

65.9 62.1 

83.9 87.0 

0 

25 

50 

75 

100 

Overall Any private Public only Uninsured 

Percent with Pap test within last year 

Percent with Pap test within last 3 years 

Percent 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

HC-070, 2002 

a Pap test at recommended intervals, by 
Figure 7. Men age 50 to 64 who received a 

PSA test at recommended intervals, 

by health insurance status, 2002 

28.5 

22.2 

33.9 

45.5 42.0 45.4 

54.4 

58.7 

0 

25 

50 

75 

Overall Any private Public only Uninsured 

Percent with PSA test within the last year 

Percent with PSA test within the last 2 years 

Percent 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

HC-070, 2002