Description
For all persons, ERPREXOPR captures the sum of direct payments made by other private insurance source for "separately billing doctor," or SBD, expenses associated with all visits to emergency room medical providers. SBD expenses include those for services provided to patients in hospital settings by providers like radiologists, anesthesiologists, and pathologists, whose charges are often not included in hospital bills. Payments for over-the-counter drugs and indirect payments not related to specific medical events, such as Medicaid Disproportionate Share and Medicare Direct Medical Education subsidies, are not included in this amount.
AHRQ staff advises users to exercise caution when interpreting the expenditures recorded in ERPREXOPR. While these payments stem from apparent inconsistent responses to the health insurance and source of payment questions in the survey, some of these inconsistencies may have logical explanations. For example, private insurance coverage in MEPS is defined as having a major medical plan covering hospital and physician services. If a MEPS sample person did not have such coverage but had a single service type insurance plan (e.g., dental insurance) that paid for a particular episode of care, those payments may be classified as "other private." For more information on how MEPS collects expenditure data, please refer to our user note on medical expenditures.
Note that hospitals usually include expenses associated with emergency room visits that immediately result in an inpatient stay with the charges and payments for the inpatient stay. Therefore, to avoid the potential for double counting when imputing missing expenses, separately reported facility expenditures for emergency room visits that were identified in the Medical Provider Component (MPC) as directly linked to an inpatient stay were included as part of the inpatient stay only (see HPCHGTOT and HPFCHT). This strategy to avoid double counting resulted in $0 facility expenditures for these emergency room visits (but there still may be associated separately-billing doctor expenses). However, these $0 emergency room visits are still counted as separate visits in the utilization variable ERTOTVIS.
Variables related to total annual health care expenditures by source of payment, total annual health care expenditures by type of medical service, and total annual health care charges are also available. Please refer to our user note on expenditures for a list of these variables.
ERPREXOPR is a 6-digit numeric variable.
Universe
- 1996-2018: All persons.
Availability
- 1996-2018
Weights
- 1996-2018 : PERWEIGHT
