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Scientific Data Documentation
Dental Visit Data, 1987

NMES87-Dental.ZIP

This compressed file contains 2 data sets for the NMES 1987 dental visit data:

	DATA
	SRC


DATA PURCHASE AND USE AGREEMENT
 Individual identifiers have been removed from the micro-data tapes available
 from the Agency for Health Care Policy and Research through NTIS.
 Nevertheless, under sections 308(d) and 903(c) of the Public Health Service
 Act (42 U.S.C. 242m and 42 U.S.C. 299 a-1), data collected by the Agency for
 Health Care Policy and Research may not be used for any purpose other than
 the purpose for which it was supplied.  The information on the micro-data
 tapes available for purchase was supplied to the Agency for statis and
 health services research.  It is necessary, therefore, that the indiviual
 such micro-data tapes sign the following assurance:

 The undersigned gives assurance that individual elementary unit data on the
 micro-data tapes being ordered will be used solely for statistical summaries
 and health services research.
BACKGROUND

     This documentation describes one in a series of public use
     tapes issued by the Agency for Health Care Policy and Research
     with data from the National Medical Expenditure Survey.  This
     survey provides extensive information on health expenditures by
     or on behalf of families and individuals, the financing of these
     expenditures, and each person's use of services.  The National
     Medical Expenditure Survey (NMES) is a research project of the
     Center for General Health Services Intramural Research, Agency
     for Health Care Policy and Research.

       Since the 1970s the intramural research program has given
     particular emphasis to studies of the use and financing of health
     services.  The first series of studies (NMES-1) employed data
     collected in the 1977 National Medical Care Expenditure Survey.
     NMES-1 produced information on a broad range of issues such as
     the number and characteristics of the uninsured and the
     underinsured, the tax implications of excluding employer-paid
     premiums for health insurance from employee income, and the
     differences among socioeconomic and demographic groups with
     respect to the use of health services.

       A new series of studies (NMES-2) was initiated in the 1980s.
     These studies also involve a major data collection effort - the
     1987 National Medical Expenditure Survey.  Like its predecessor,
     NMES-2 provides information about the non-institutionalized
     population.  In addition and in contrast to the earlier studies,
     NMES-2 also provides extensive information on the population
     residing in or admitted to nursing homes and facilities for the
     mentally retarded.

       The Household Component of NMES-2 is based on a national
     probability sample of the civilian, noninstitutionalized
     population living in the community.  The sample is designed to
     provide a larger representation of population groups of special
     policy interest to the Federal Government than would have been
     obtained from a random sample.  These groups include poor and low
     income families, the elderly, the functionally impaired, and
     black and Hispanic minorities.  A Survey of American Indians and
     Alaska Natives includes a separate sample of American Indians and
     Alaska Natives living on or near Federal reservations and
     eligible to receive care provided or supported by the Indian
     Health Service.  The Institutional Population Component includes
     a sample of persons residing in or admitted to nursing and
     personal care homes and facilities for the mentally retarded
     during 1987.  A separate Medicare Records Component provides
     claims data on all Medicare beneficiaries included in the
     household and institutional samples.

       Together, the major components of NMES-2 contain information to
     make national estimates of health status, use of health services,
     insurance coverage, expenditures, and sources of payment for the
     civilian population of the United States during the period from
     January 1 to December 31, 1987.  Oversampling of population
     groups of special interest makes possible in-depth studies of
     these groups.  The database can also be used to assess the
     implications of recent or proposed changes in public or private
     health care benefits, methods of financing both health care and
     insurance coverage, various public and private subsidies for
     health care, and employee compensation arrangements.

 Household Survey

       Each family in the Household Survey was interviewed four times
     over a period of 16 months to obtain information about the
     family's health and health care during calendar year 1987.
     Baseline data on household composition, employment, and insurance
     were updated at each interview, and information was obtained on
     illnesses, use of health services, and health expenditures for
     each family member.  A fifth round of interviews was conducted in
     the spring of 1988 to obtain information on the tax filing and
     medical deductions of each household.  A long term care
     supplement was administered during the first and fourth rounds of
     interviewing to permit estimates of persons with functional
     disabilities and the use of formal services or long term care
     provided by family or friends.

       In order to verify and supplement the information provided by
     household respondents, the Household Component of NMES-2
     included two additional surveys.  The Medical Provider Survey
     obtained information from the physicians, hospitals, outpatient
     clinics, emergency rooms, and home health agencies used by the
     household sample during 1987.  The Health Insurance Plan Survey
     obtained information on the private insurance of persons in the
     household sample, including premiums paid by all sources and the
     provisions of their coverage.

 Survey of American Indians and Alaska Natives (SAIAN)

       This component was conducted with the same data collection
     instruments and interview procedures as the Household Component
     and covered the same reference period, calendar year 1987.  SAIAN
     also included follow-up surveys to medical providers and health
     insurers.  Consequently, the data can be used to compare American
     Indians and Alaska Natives eligible for care from the Indian
     Health Service and the general U.S. population with regard to
     such issues as health status, use of health services, and access
     to  care.  Information was obtained on services provided outside
     the Indian Health Service and on other sources of health care
     financing available for persons eligible for care from the IHS.

 Institutional Population Component

       The Institutional Population Component of NMES-2 included
     persons resident in or admitted to nursing and personal care
     homes and facilities for the mentally retarded at any time in
     calendar year 1987.  This survey provides information on the
     functional status, use of services, and health expenditures of
     the institutionalized population.  The Survey in Institutions
     (SII) collected data from facility administrators and designated
     staff on the characteristics of facilities and charges.  The
     Survey of Next of Kin (SNK) obtained data from the respondent's
     next-of-kin or other knowledgeable persons in the community on
     the financial status, insurance coverage, and personal history of
     the institutionalized person.

 Survey Samples

       All survey components were designed to provide statistically
     unbiased estimates that are representative of the civilian
     population of the United States in 1987.  The Household Survey
     sample is a stratified multistage area probability design with a
     total sample of roughly 35,000 individuals, in 14,000 households,
     who completed all rounds of data collection.  Oversampling of the
     population subgroups of special policy interest was based on a
     separate screening interview conducted in the fall of 1986 with a
     sample of 36,000 addresses.

       The Survey of American Indians and Alaska Natives adopted a
     multistage area probability sample design using an IHS-
     constructed frame of counties with individuals eligible for
     services provided or supported by the Indian Health Service and
     living on or near Federally recognized reservations or in Alaska.
     An initial screening interview was completed in approximately
     13,700 dwelling units to identify the eligible sample.  The
     screening yielded approximately 1,950 households responding for
     the full year and approximately 6,500 SAIAN persons responded for
     their entire period of eligibility in 1987.

       The institutional population sample was based on a three stage
     probability design.  The first two stages were used to select
     facilities; the final stage sampled facility residents present on
     January 1, 1987.  These facilities were also used to obtain a
     sample of admissions between January 1, 1987, and December 31,
     1987.  Based on sampling specifications the Institutional
     Population Component includes 1,500 facilities, 800 nursing homes
     and 700 facilities for the mentally retarded.  There is a total
     of approximately 10,100 persons in the sample including both
     residents and new admissions.  This includes 5,700 persons in
     nursing homes and 4,400 persons in facilities for the mentally
     retarded.  The sample frame for facilities in the Institutional
     Population Component was derived from the 1986 Inventory of Long-
     Term Care Places.

       Taken in conjunction, the NMES-2 surveys yield comprehensive,
     population-based information that will support studies of most
     population groups of policy interest, including those presently
     outside the scope of various public and private financing
     mechanisms.  In contrast to information obtained from program or
     provider statistics, NMES-2 data can be used to analyze all
     public and private sources of coverage for health care services
     and out-of-pocket payments by individuals and families.

       The Agency for Health Care Policy and Research sponsored the
     NMES-2 data collection activities.  A substantial part of the
     support for the Survey of American Indians and Alaska Natives was
     provided by the Indian Health Service.  The Health Care Financing
     Administration, the National Center for Health Statistics, and
     the Office of the Assistant Secretary for Planning and Evaluation
     provided extensive technical assistance during the development of
     the survey design and instruments.  Interviews were conducted by
     the primary contractor, Westat, Inc., Rockville, Maryland and the
     National Opinion Research Center at the University of Chicago;
     the Council of Energy Resource Tribes, Denver, Colorado; and
     Stephen R. Braund and Associates, Anchorage Alaska.  Data
     processing during the analysis stage of the project is being
     provided by Social and Scientific Systems, Inc., Bethesda,
     Maryland.

       The data were collected under the authorities of the Public
     Health Service Act and are being edited and published in
     accordance with the confidentiality provisions of that Act and
     the Privacy Act.

       Additional information on NMES-2 is available from Daniel C.
     Walden, Ph.D., Director of the Division of Medical Expenditure
     Studies; Center for General Health Services Intramural Research,
     Agency for Health Care Policy and Research; 2101 East Jefferson
     Street, Suite 500, Rockville, Maryland, 20852 (301/227-8400).


TECHNICAL AND PROGRAMMING INFORMATION

 General

       This documentation describes one in a series of public use
     tapes from the Household Survey of the 1987 National Medical
     Expenditure Survey (NMES).  The tape provides information and
     related documentation on the use of and expenditures for dental
     visits for calendar year 1987.  The data file contains one record
     per dental visit for each eligible person in the Household Survey
     who reported a dental visit during 1987 and who responded for
     their entire period of eligibility.  In addition, each record
     contains basic person-level demographic information for the
     sample person, type of service obtained during the dental visit,
     dates of service, and medical condition (ICD9-HIS codes) if the
     visit was due to accident or injury.  The file can be used to
     construct summary variables of expenditures, sources of payment,
     and other aspects of utilization of dental services.  NMES Public
     Use Tape 13 provides information on persons in the Household
     Survey without dental visits in 1987 and annual person-level
     information on other health services use as well as detailed
     demographic, employment and insurance information, round specific
     eligibility status indicators and reference period dates for the
     entire civilian noninstitutionalized population.

       The data on this tape are being released as EBCDIC files only.
     The tape includes an EBCDIC file containing programming
     statements required to create a SAS data set and a SAS format
     library for the data file on the tape.

       The following documentation offers a brief overview of the type
     and level of data provided, the content and structure of the data
     file and the codebook, and programming information.  It contains
     the following sections:

       Data File Structure and Contents
       Variable Naming and Codebook Conventions
       Sample Design, Estimation and Sampling Weights, and Variance
        Estimation
       Programming Information
       Data Dictionary
                    Alphabetical and Position Listing of Variables
                    Codebook
                    Codebook Notes

      More detailed information on NMES survey instruments and data
     collection procedures, variance estimation programs, and coding
     and related information are in Attachments 1 to 5, which are
     provided as hard-copy attachments to the documentation.
     Attachment 6 contains a catalogue of data items released on this
     and other NMES public use tapes.  It is supplied to guide the
     user to the appropriate public use tape for the data items of
     interest in the NMES Household Survey.

 Data File Structure and Contents

  General Information

       This public use tape contains one data file.  The file
     structure generally reflects the structure of the household
     questionnaire (see Attachments 1 and 3 for the instruments used).
     The file contains information on dental visits, expenses, and
     sources of payment as obtained in four rounds of interviews
     covering calendar year 1987.  The persons represented on this
     file include all persons in the NMES household sample who used
     dental services in calendar year 1987 and responded for their
     entire period of NMES eligibility.  The file contains 38,429
     records, or one record for each dental visit.  A dental visit is
     defined as a single contact for one or multiple services with a
     dentist, dental surgeon, oral surgeon, orthodontist, dental
     assistant, or any other person for dental care.  Repeat visits
     are counted as individual visits.

               Each record on the data file contains the following
     information:

               Unique person and visit identifiers

               Indicator of the round of data collection

               Selected demographic variables

               Variables based on questionnaire items D1 through D11
               in the dental visit booklet.  These include the date
               and type of service, ICD9-NHIS codes representing the
               conditions for dental services resulting from accident
               or injury, and total expense and sources of payment for
               all dental services as well as associated imputation
               flags.

               Weight and variance estimation variables

       Detailed information on coding medical conditions related to
     each dental visit and the type of dental service provided can be
     found in Sections C.1.1 and C.1.2.  The construction of the
     expense and source of payment variables and associated imputation
     procedures are described in Section C.1.3.  Miscellaneous edits
     and omissions are discussed in Section C.1.4.  Additional detail
     for selected variables is provided in the codebook notes at the
     end of the codebook (see section D).

       The records on this file can be linked to all public use data
     sets from the Household Survey by using the person identifier
     (PIDX).

  Coding of Medical Conditions

       Coding of Medical Conditions for Visits Related to
               Accidents and Injuries

       This file contains a maximum of two condition codes per dental
     visit resulting from accident or injury as reported by the
     Household Survey respondent.  Information on the nature of the
     dental injury was used to code each condition related to the
     dental visit into one of the codes of the 9th Revision of the
     International Classification of Diseases revised for use in the
     National Health Interview Survey (NHIS; NCHS, 1979).  The
     revision takes into account the experience of the National Center
     for Health Statistics, the sponsor of the NHIS, in coding
     household reported conditions.  Coding instructions directed
     coders to favor X-codes over other relevant ICD-9 codes.
     Attachment 4 provides details of the NHIS coding scheme for X-
     codes.

       The first condition on the record does not necessarily reflect
     the primary condition for the sample person nor its importance or
     severity.  In addition, there is a small probability that
     duplicate conditions are attached to the same record.  No editing
     for these duplications has been provided.

       Coding was conducted by trained medical coders.  Two-stage
     verification of the coding was performed first by supervisors and
     then by trained nosologists.  Coders were required to maintain an
     error rate at or below 2 percent throughout the coding process.

  Type of Service

       An edited variable reflects type of dental service received
     during each visit (TYPESRVX).  TYPESRVX was created using data
     from each category of Question D7, including the variable
     DENTOTHR.  Data were missing on type of visit for 216 dental
     visits (less than 1 percent) reported during the four
     interviewing rounds of the Household Survey.  For missing cases
     in which the user had only one other visit to the same provider
     during the year, type of service was imputed logically by
     assigning the same service type.  If there was more than one
     other visit to the same provider, service type was assigned based
     on the total visit expense closest in value to the original visit
     without type of service information.  If type of service could
     not be imputed with either method, it was randomly assigned based
     on the relative frequency of service type for all dental visits
     with known data for this variable.

 Expenses and Sources of Payment

  Total Expense for Dental Visit

       The data file contains both the unedited charge (EXPTOT) and
     edited (EXPTOTX) total expense for each dental visit by the
     sample person during the reference period.  These variables
     reflect all amounts paid out of pocket and by third party sources
     for services related to each dental visit during 1987 for each
     sample person who responded for his or her entire period of NMES
     Household Survey eligibility.  There are no dental visits with
     zero expenses on this file.

       In settings that do not normally specify a total charge, a
     dollar value was imputed to construct a total expense variable.
     For example, there was no explicit total charge for many visits
     to an HMO or other prepaid providers where care is financed
     through a capitation payment rather than on a fee-for-service
     basis.  This was also the case for providers financed by Federal,
     State or local government, by charities, and similar
     organizations who do not specify charges for their services or
     provide services free of charge.

       The edited total expense variable (EXPTOTX) adjusts for such
     missing or inconsistent expense values by a series of edits and
     imputation procedures.  These addressed three major issues: (1)
     potential copayment amounts, which were mainly charges reported
     at the lower extreme of the total expense distribution; (2)
     potential flat fees, which encompassed multiple visits over a
     course of treatment and were mainly visit charges at the upper
     extreme of the total expense distribution; and (3) missing
     charges where care was delivered free from the provider or under
     a prepaid arrangement such as an HMO, covered by a flat fee or by
     Medicaid, or otherwise not reported by the respondent.

       In cases where a flat fee was associated with multiple visits
     for the same type of service, the fee was distributed over the
     number of visits.  Visits that were identified as "free from
     provider", under a prepaid arrangement or missing charge data
     were imputed, using a weighted sequential hot-deck procedure, to
     reflect the market value of services.  The imputation variables
     were type of service (TYPESRVX), SMSA status, and designations by
     state in the Geographic Medicare Economic Index (GMEI).  The
     weighted sequential hot-deck procedure imputes data for visits
     with complete information to visits with missing data but similar
     characteristics.  Variables with known values for type of service
     are used to form groups of donors with known data on expenses and
     identical groups of recipients with missing data.  Within such
     groups, data were assigned from donors to recipients, taking into
     account the weights associated with each visit in the complex
     NMES household survey design.

       Medicaid expenses were imputed using a database consisting of
     average 1987 Medicaid reimbursements by state, patient age, and
     type of service for dental care.

       All imputations were performed at the level of a single visit
     with the exception of repeat visits (see section C.1.4).  Each
     record with imputed values contains a corresponding imputation
     flag.  In total, approximately 25 percent of expense information
     was edited or imputed.

  Sources of Payment

       Each record on the file contains 9 constructed variables which
     sum to 100 percent, corresponding to the percent of the total
     expense paid by each of the following sources:

               Out of pocket by user or family;

               Private insurance; including any dental plans;

               Medicaid;

               Medicare (the Medicare source of payment variable
               contains primarily zero values because Medicare, in
               1987, did not pay for dental visits in general,
               although it did cover dental care meeting specific
               stipulations);

               Other Federal programs, which include CHAMPUS, CHAMPVA,
               Supplemental Security Income (SSI), Indian Health
               Service facility or contract, Intertribal Council,
               Alaska Native Corporation, Veteran's Administration,
               any military and other federal programs such as free
               government screening services and NIH care;

               Other State and local medical assistance programs such
               as community health centers (excludes local and state
               employment related insurance and welfare programs);

               Workers compensation;

               Free from the provider, including professional courtesy
               and bad debt, and;

               Other, which includes automobile and car insurance,
               other kinds of insurance not specified, company (where
               the company is not the insurer), school (where the
               school is not the insurer or employer), union (where
               the union is not the insurer or employer), charity,
               friend, foreign government, or not otherwise specified.

     Based on respondent reports of the percent or amount paid by each
     of these sources of payment, the source of payment variables were
     edited and, where necessary, imputed to correct for the
     following:  (1) the payer reported by the household was
     incompatible with enrollment in public and private insurance
     programs reported for the person; (2) the person was not billed
     reported; (3) the sum of the reported sources did not equal 100
     percent; or (4) the sources of payment or the amounts or
     proportions of the payment were partially or completely missing.
     Logical edits for sources of payment were performed in those
     cases where enough information existed.  When only a partial
     source of payment was available and no logical edit was possible,
     the total distribution of sources of payment was imputed.

       As for total expenses, the general imputation strategy for
     sources of payment used a weighted sequential hotdeck procedure.
     The classification variables used in the source of payment
     imputation included insurance coverage, region, date of visit,
     whether the respondent had reported a specific charge, and union
     membership of the primary insured.  Each record with imputed
     values contains a corresponding imputation flag.

       The source of payment data have not been reconciled with the
     variable (DENTVA), which indicates that the dental clinic is a
     facility of the Veterans Administration.

 Other Edits and Omissions

       Some data items from the dental visit booklet were omitted from
     this file.   Omitted variables were not considered to be of
     independent analytic interest but rather, were methodological
     probes to insure that the respondent had provided complete
     utilization and expenditure information.  The expense and source
     of payment variables included on this file reflect all of the
     components collected in the dental visit section of the
     questionnaire.

       Questions pertaining to repeat visits (D26-D30) are not
     separate variables on this file.  Instead, to increase data
     processing efficiency, the data collected in these questions are
     represented as separate records, with each record representing a
     single dental visit.  VISITIDX is the unique record identifier
     for each dental visit.  It concatenates ODU, PN, EN, and RVISN.
     ODU is the original dwelling unit.  PN is the person number.  The
     event number EN identifies an initial contact with a given
     provider for specific services during a round.  RVISN is the
     numerical identifier for any repeat visit within one data
     collection round to the same provider for the same services at
     the same expense.  The value for RVISN for the first visit equals
     zero and all repeat visits associated with that visit are
     numbered consecutively (RVISN = 1 to n).  The first visit and all
     repeat visits share the same event number.  All characteristics
     of the initial visit except the date are assigned to the repeat
     visits.  Similarly, if data for the initial visit were edited or
     imputed, then the edited or imputed values were also assigned to
     the repeat visits.  About 20 percent of the total dental visits
     were repeat visits.

       Unless indicated, all Dental Booklet variables are unedited.
     Skip patterns associated with unedited variables have not been
     reconciled.  No editing was performed on the round indicator on
     this file.  However, editing was performed on all link variables.

 Variable Naming and Codebook Conventions

       The codebook provides unweighted and weighted frequencies for
     all variables on the file.  The codebook contains variable
     information and frequency distributions for a total of 38,429
     records (i.e. visits).  Weighted, these records represent
     291,766,756 dental visits by 101,563,130 persons (13,439
     unweighted).

       Complete variable listings in alphabetical order and by file
     position are provided for cross-reference.  Most variable
     descriptors in the codebooks are abbreviated versions of
     questionnaire items, preceded by indicators of item number.  A
     copy of the round 2 dental visit booklet is included as
     Attachment 3 to this public use tape to permit a full
     understanding of the content and wording of each item, the
     structure of questionnaire sections, skip patterns and
     administrative information.

       The codebook describes an EBCDIC data set and provides the
     following programming identifiers for each variable:

       IDENTIFIER                       DESCRIPTION

       NAME                   Variable name (maximum of 8
                              characters)

       DESCRIPTION            Variable descriptor (maximum of 40
                              characters)

       FORMAT                 Number of bytes and decimal places

       TYPE                   Type of data:  numeric (indicated by
                              NUM) or character (indicated by CHAR)


       START                  Beginning column position of variable in
                              the record

       END                    Ending column position of variable in
                              the record

       NOTES                  Indicator of an explanatory note(s)
                              corresponding to the variable.
                              Explanatory notes can be found in the
                              Codebook Note section.

       In general, variable names reflect the content of the variable,
     with an 8 character limitation.  For edited versions of original
     variables, the edited variable name is identical to the original
     variable with an "X" appended (and truncated when necessary to
     comply with the 8 character limitation).  For variables
     corresponding to specific questionnaire items, the question
     number is included in the variable label.


       The following reserved code values are used:

       VALUE                            DEFINITION

       -1 INAPPLICABLE        Question was not asked due to skip
                              pattern

       -5 NEVER KNOW          Question was asked and respondent did
                              not know and never will know the answer

       -7 REFUSED             Question was asked and respondent
                              refused to answer the question

       -8 DK                  Question was asked and respondent did
                              not know the answer

       -9 NOT ASCERTAINED     Interviewer did not record the data


 Sample Design and Variance Estimation

  Sample Design and Response Rates

       The NMES household survey was designed to produce national
     estimates representative of the civilian noninstitutionalized
     population of the United States as of 1987.  For sample
     selection, the household component of NMES used two independent
     national multistage area samples from Westat, Inc. and the
     National Opinion Research Center at the University of Chicago.
     To improve the quality of the data and to allow for analysis of
     trends during 1987, the Household Survey was conducted as a panel
     survey over four core rounds of interviewing.

       Sampling specifications required the selection of about 17,500
     households for the first core household interview.  Data were
     obtained for about 86 percent of eligible households in the first
     interview and 80 percent by the fourth interview.  Approximately
     6 percent of all survey participants provided data for only some
     of the time in which they were eligible to respond.  These
     persons were considered total nonrespondents and a standard
     nonresponse weight adjustment was used to account for possible
     selection bias in this respect.  For a detailed description of
     the survey design and of sampling, estimation, and adjustment
     methods see Cohen, DiGaetano, and Waksberg (1991).

 Estimation and Sampling Weights

  General Information

       The application of appropriate sampling weights is essential to
     the derivation of valid estimates using this public use file.
     The weight provided for use with dental visit data, INCALPER,
     reflects adjustments for complete nonresponse to the NMES survey
     and poststratification to the Census Bureau 1987 Current
     Population Survey (CPS) cross-classified by age, race/ethnicity,
     gender and poverty status.  All persons who were eligible at any
     time during 1987 and responded for the entire period of their
     eligibility have positive INCALPER weights, yielding 13,439
     persons with positive INCALPER weights and at least one dental
     visit.  In order to produce national estimates related to the
     frequency, expenses and sources of payment for dental care, the
     value in each record contributing to the estimates must be
     multiplied by the weight (INCALPER) on that record.  It should be
     noted that this weight, which is also provided on NMES Public Use
     Tape 13, can also serve as a person-level estimation weight.

       For estimates involving persons in the Household Survey not on
     this file (i.e., persons without use of dental services in 1987)
     or for detailed person-level characteristics of users, including
     round specific eligibility status and reference period dates, the
     data on this file should be merged with NMES Public Use Tape 13,
     using the person-level identification variable PIDX.  Information
     on appropriate tape merges is provided below (C.3.3).

 Basic Estimates of Utilization and Expenditures

       This file is constructed for efficient estimation of
     utilization and expenditures for dental care, including the total
     number of and expenses for dental visits.  The mean expense for
     dental visits, for instance, should be calculated as the weighted
     sum of the total expenditures across all records in the file (sum
     of EXPTOTX x INCALPER) divided by weighted sum of the number of
     visits (sum of INCALPER).  Thus, the numerator is the national
     estimate for total expenditures for dental visits and the
     denominator is the population estimate for the total number of
     dental visits.

       Subsetting to records based on characteristics of interest
     expands the scope of potential estimates.  For example, the
     number of dental visits paid for, totally or in part, by private
     insurance is estimated by summing INCALPER across all records
     where the private insurance source of payment variable (SOPTPRVT)
     is greater than zero.

  Person-Based Ratio Estimates

       Person-Based Ratio Estimates for Persons with Dental Visits

       When calculating ratio estimates where the denominator is
     persons instead of dental visits, care should be taken to
     properly define and estimate this denominator.  If the estimate
     of interest, for example, is the mean expense for all dental
     visits across all users of dental services, the following
     strategy should be considered:  All expenses for a person on this
     file should be summed and a person-level total expense variable
     created (e.g., the variable X).  The mean national estimate would
     then be derived by obtaining the ratio of the weighted sum of
     total expenses per person across all unique persons on the file
     (the sum of INCALPER multiplied by the variable X) divided by the
     weighted number of unique persons on the file (sum of INCALPER).
     Only one INCALPER value for each PIDX (person) should contribute
     to the calculation of the sums for both the numerator and the
     denominator.

       Person-Based Ratio Estimates Relative to the Entire Population

       If the ratio relates to the entire population, this file cannot
     be used to calculate the denominator, as only those persons with
     at least one dental visit are represented on it.  In this case,
     Public Use Tape 13 -- Rounds 1-4 Household Survey: Population
     Characteristics and Person-level Utilization, which has data for
     all sample people, must be used to estimate persons.  For
     example, to estimate the proportion of persons 65 and over with
     at least one dental visit which included denture repair, the
     current file is used to calculate the numerator and NMES Tape 13
     is used to calculate the denominator.

  Sample Weights for Merging Previous Releases

         Sampling Weights for Merging Previous Releases of NMES
               Household Data with the Current Tape

       There have been several previous releases of NMES Household
     Survey public use data (see Attachment 5).  Unless a variable
     name common to several tapes is provided, the sampling weights
     contained on these tapes are tape-specific.  The tape-specific
     sampling weights reflect minor adjustments to eligibility and
     response indicators due, among other factors, to birth, death, or
     institutionalization among respondents.  Adjustments to the
     weights have also included post-stratification adjustments to
     control for the distribution of the U.S. noninstitutionalized
     population by poverty status and, where appropriate, nonresponse
     adjustments for round-specific supplemental questionnaires (e.g.,
     the health status questionnaires on Tape 9).

       For estimates from a NMES data file that do not require merging
     with variables on other NMES files, the sampling weights provided
     on that tape are the appropriate weights.  When merging a NMES
     household survey tape to another NMES household survey tape, the
     major analytical variable (i.e., the dependent variable)
     determines the correct sampling weight to use.  For example, for
     1987 estimates of dental care use or expenditures (from the
     present household survey tape) using health status variables from
     NMES Public Use Tape 9, the full-year weight, INCALPER, on the
     present tape should be used.  By contrast, the weight HSQACCWT
     from Public Use Tape 9 should be used for when the major
     dependent variable is health status and dental visit is an
     independent variable.  Three exceptions to this general sampling
     weight and merger rule are noted below.  Details concerning the
     appropriate weight specific to each tape are given in the
     documentation for each tape.

               (1) For estimates of round one data from NMES
               Public Use Tape 3 (preliminary round one person
               characteristics and functional health status data), the
               round one weight (WGTR1PER) provided on NMES Public Use
               Tape 13 should be used.  It should be noted that as a
               result of further response and eligibility edits, not
               all persons with positive round one weights on Tape 3
               will link when merging to Tape 13.  In those
               instances, an imputation or weighting strategy can be
               developed to adjust for all persons with positive
               WGTR1PER weights.

               (2) For point in time estimates of persons with
               activity of daily living and instrumental activity of
               daily living difficulties (Tape 10), the round one or
               four weight (WGTR1PER and WGTR4PER, respectively),
               provided on NMES Tape 13 should be used in all
               instances of merged data regardless of the type of
               analysis.

               (3) NMES Public Use Tape 4, which contains prescribed
               medicine data for the Medicare beneficiary population,
               should not be merged with the current tape (or any
               other NMES public use file) because of adjustment to
               the sampling weights made after the release of Tape 4.

       It should be noted that the sampling weight provided on NMES
     Tape 9 (HSQACCWT) reflects nonresponse adjustments specific to
     the health status questionnaire and access to care supplement
     data on that tape.  This further nonresponse adjustment requires
     additional considerations in merging Tape 9 with the current
     tape.

               (1) When making estimates for data in the current tape,
               the sampling weights provided on the current tape
               should be used.  Since this would include persons not
               on Tape 9 in the analysis, data items from Tape 9 will
               have missing values for these persons.

               (2) When making estimates of health status or access to
               care indicators, the Tape 9 weight, HSQACCWT, should be
               used.  This weight adjusts for the exclusion of persons
               included on the present tape.

  Variance Estimation

       Variance estimates of sample statistics require that the
     complex nature of the NMES Household Survey design be taken into
     account for hypothesis testing and for the construction of
     confidence intervals.  To obtain variance estimates of statistics
     by means of statistical programs that use the Taylor series
     method of variance estimation, variables must be used that denote
     the strata and the primary sampling unit (PSU) within a given
     stratum.  The variables STRATUMX and SPSU are these variables,
     respectively and are included on the data file.

       There are variance estimation programs that account for the
     complex survey design.  A list of available variance estimation
     programs is produced in Attachment 2.

 Programming Information

       These files are contained on a standard label, 9 track 6250 bpi
     tape.  The specifications for each file on the tape are as
     follows:

     FILE 1:
     Description:  NMES Household Survey Dental Visit Data File
     Dataset Name:  NMES.PUF143.DATA
     Number of Observations: 38,429
     Number of Variables:  53
     Record Length:  220
     Block Size:  11,000
     Record Format:  FB

     FILE 2:
     Description:   Technical and Programming Information and Data
                    Dictionary for the NMES HHS Dental Visit Data File
     Dataset Name:  NMES.PUF143.DOC
     Record Length:  133
     Block Size:  19,950
     Record Format:  FB

     FILE 3:
     Description:   Additional Documentation for SAS Users for the
                    NMES HHS Dental Visit Data File
     Dataset Name:  NMES.PUF143.SRC
     Record Length:  80
     Block Size:  800
     Record Format:  FB
       File 1 was created using the SAS (Statistical Analysis System,
     version 5.18) computer software, and converted to EBCDIC format.
     File 2 contains the technical documentation stored as an
     Operating System (OS) EBCDIC file containing ASA carriage control
     characters in the first byte in each record, which will direct
     the line printer to skip lines, begin a new page, etc.  This
     technical documentation can be copied to disk and retrieved on-
     line to view, to modify with a text editor program such as
     WYLBUR, or to make additional copies.  File 3 is an EBCDIC file
     containing the following additional documentation for SAS users:
     INPUT statement to create the SAS file, including a LABEL
     statement; SAS statements which assign a format name to each
     variable; and SAS statements describing formats.

 References

     Cohen, S.B., DiGaetano, R. and Waksberg, J. (1991).  National
       Medical Expenditure Survey:  Sample Design of the 1987
       Household Survey, Methods 3.  AHCPR Pub. No. 91-0037.  DHHS:
       U.S. Public Health Service.

     National Center for Health Statistics (1979).  Medical Coding
       Manual: National Health Interview Survey.  DHHS: U.S. Public
       Health Service.


RECORD LAYOUT

 Alphabetical listing of Variables

                     DATA DICTIONARY
                  NMES DENTAL VISIT CODEBOOK
       ALPHABETICAL AND POSITIONAL LISTING OF VARIABLES
                   DATE:     MARCH 26, 1992
          -----ALPHABETICAL LISTING OF VARIABLES-----
   START      END   NAME       DESCRIPTION
   -----      ---   ----       -----------
      98       99   BRIDGES    D7 BRIDGEWORK THIS VISIT
      84       85   CLENTETH   D7 TEETH CLEANED THIS VISIT
      96       97   CROWNS     D7 CROWN(S) THIS VISIT
      70       71   DENTINJ    D4 DENTAL VISIT DUE TO ACCIDENT/INJURY
     104      105   DENTOTHR   D7 OTHER DENTAL WORK THIS VISIT
     100      101   DENTURES   D7 DENTURES THIS VISIT
      68       69   DENTVA     D3 DENTAL CLINIC IS A FACILITY OF THE VA
      80       81   DENTXRAY   D6 X-RAY THIS VISIT
      60       61   DNDATEDD   D1 DATE OF DENTAL VISIT - DAY
      58       59   DNDATEMM   D1 DATE OF DENTAL VISIT - MONTH
      62       63   DNDATEYY   D1 DATE OF DENTAL VISIT - YEAR
       9       12   EN         EVENT NUMBER
      23       34   EVENTIDX   EVENT ID (ODUX + PN + EN)
      86       87   EXAMINE    D7 EXAMINATION THIS VISIT
     122      122   EXPTFLG    IMPUTATION FLAG FOR EDITED TOTAL EXPENSE
     108      114   EXPTOT     D11 ORIGINAL TOTAL DENTAL CHARGE
     115      121   EXPTOTX    EDITED TOTAL DENTAL EXPENSE
      92       93   EXTRACT    D7 EXTRACTION(S) THIS VISIT
      66       67   FACTYPE    D2 TYPE OF DENTAL FACILITY
      90       91   FILLING    D7 FILLING(S) THIS VISIT
      72       75   ICD1       D5 ICD9 CODE - CONDITION 1
      76       79   ICD2       D5 ICD9 CODE - CONDITION 2
     196      197   IHSFAC     D31 DENTAL FACILITY IHS OR TRIBE/ANC
     198      209   INCALPER   FULL-YEAR WEIGHT
      82       83   JUSTXRAY   D7 ONLY X-RAY THIS VISIT
      51       53   LASTAGE    ED PID AGE AT END OF LAST ELIGIBLE ROUND
       1        5   ODUX       ORIGINAL DWELLING UNIT OF PERSON
      88       89   ORTHDONT   D7 ORTHODONTIA THIS VISIT
      15       22   PIDX       PERSON NUMBER (ODUX + PN)
       6        8   PN         PERSON NUMBER
      64       65   PROVCOD    D2 SPECIALTY OF PROVIDER
      56       56   RACE3      PID RACE/ETHNICITY
      55       55   RACE6      ED PID RACE
     102      103   REPAIR     D7 BRIDGE/DENTURE REPAIR THIS VISIT
      94       95   ROOTCANL   D7 ROOT CANAL(S) THIS VISIT
      49       50   ROUND      DATA COLLECTION ROUND
      13       14   RVISN      VISIT NUMBER
      54       54   SMPSEXR    PID SEX
     187      194   SOPTFFP    PCT PAYMENT FREE FROM PROVIDER
     195      195   SOPTFLG    IMPUTATION FLG FOR SOURCE OF PAYMENT
     147      154   SOPTMCD    PCT PAYMENT FROM MEDICAID
     139      146   SOPTMCR    PCT PAYMENT FROM MEDICARE
     155      162   SOPTOTFD   PCT PAYMENT FROM OTHER FEDERAL
     179      186   SOPTOTHR   PCT PAYMENT FROM OTHER
     163      170   SOPTOTST   PCT PAYMENT FROM OTHER STATE
     131      138   SOPTPRVT   PCT PAYMENT FROM PRIVATE INSURANCE
     123      130   SOPTSELF   PCT PAYMENT FROM SELF OR FAMILY
     171      178   SOPTWC     PCT PAYMENT FROM WORKERS COMP
     213      213   SPSU       PSEUDO PSU
      57       57   SREGION    PID CENSUS REGION
     210      212   STRATUMX   SAMPLING STRATUM
     106      107   TYPESRVX   ED TYPE DENTAL DERVICE
      35       48   VISITIDX   VISIT ID (ODUX + PN + EN + RVISN)

 Positional Listing of Variables

             NMES DENTAL VISIT CODEBOOK
       ALPHABETICAL AND POSITIONAL LISTING OF VARIABLES
                   DATE:     MARCH 26, 1992
          -----POSITIONAL LISTING OF VARIABLES-----
   START      END   NAME       DESCRIPTION
   -----      ---   ----       -----------
       1        5   ODUX       ORIGINAL DWELLING UNIT OF PERSON
       6        8   PN         PERSON NUMBER
       9       12   EN         EVENT NUMBER
      13       14   RVISN      VISIT NUMBER
      15       22   PIDX       PERSON NUMBER (ODUX + PN)
      23       34   EVENTIDX   EVENT ID (ODUX + PN + EN)
      35       48   VISITIDX   VISIT ID (ODUX + PN + EN + RVISN)
      49       50   ROUND      DATA COLLECTION ROUND
      51       53   LASTAGE    ED PID AGE AT END OF LAST ELIGIBLE ROUND
      54       54   SMPSEXR    PID SEX
      55       55   RACE6      ED PID RACE
      56       56   RACE3      PID RACE/ETHNICITY
      57       57   SREGION    PID CENSUS REGION
      58       59   DNDATEMM   D1 DATE OF DENTAL VISIT - MONTH
      60       61   DNDATEDD   D1 DATE OF DENTAL VISIT - DAY
      62       63   DNDATEYY   D1 DATE OF DENTAL VISIT - YEAR
      64       65   PROVCOD    D2 SPECIALTY OF PROVIDER
      66       67   FACTYPE    D2 TYPE OF DENTAL FACILITY
      68       69   DENTVA     D3 DENTAL CLINIC IS A FACILITY OF THE VA
      70       71   DENTINJ    D4 DENTAL VISIT DUE TO ACCIDENT/INJURY
      72       75   ICD1       D5 ICD9 CODE - CONDITION 1
      76       79   ICD2       D5 ICD9 CODE - CONDITION 2
      80       81   DENTXRAY   D6 X-RAY THIS VISIT
      82       83   JUSTXRAY   D7 ONLY X-RAY THIS VISIT
      84       85   CLENTETH   D7 TEETH CLEANED THIS VISIT
      86       87   EXAMINE    D7 EXAMINATION THIS VISIT
      88       89   ORTHDONT   D7 ORTHODONTIA THIS VISIT
      90       91   FILLING    D7 FILLING(S) THIS VISIT
      92       93   EXTRACT    D7 EXTRACTION(S) THIS VISIT
      94       95   ROOTCANL   D7 ROOT CANAL(S) THIS VISIT
      96       97   CROWNS     D7 CROWN(S) THIS VISIT
      98       99   BRIDGES    D7 BRIDGEWORK THIS VISIT
     100      101   DENTURES   D7 DENTURES THIS VISIT
     102      103   REPAIR     D7 BRIDGE/DENTURE REPAIR THIS VISIT
     104      105   DENTOTHR   D7 OTHER DENTAL WORK THIS VISIT
     106      107   TYPESRVX   ED TYPE OF DENTAL SERVICE
     108      114   EXPTOT     D11 ORIGINAL TOTAL DENTAL CHARGE
     115      121   EXPTOTX    EDITED TOTAL DENTAL EXPENSE
     122      122   EXPTFLG    IMPUTATION FLAG FOR EDITED TOTAL EXPENSE
     123      130   SOPTSELF   PCT PAYMENT FROM SELF OR FAMILY
     131      138   SOPTPRVT   PCT PAYMENT FROM PRIVATE INSURANCE
     139      146   SOPTMCR    PCT PAYMENT FROM MEDICARE
     147      154   SOPTMCD    PCT PAYMENT FROM MEDICAID
     155      162   SOPTOTFD   PCT PAYMENT FROM OTHER FEDERAL
     163      170   SOPTOTST   PCT PAYMENT FROM OTHER STATE
     171      178   SOPTWC     PCT PAYMENT FROM WORKERS COMP
     179      186   SOPTOTHR   PCT PAYMENT FROM OTHER
     187      194   SOPTFFP    PCT PAYMENT FREE FROM PROVIDER
     195      195   SOPTFLG    IMPUTATION FLG FOR SOURCE OF PAYMENT
     196      197   IHSFAC     D31 DENTAL FACILITY IHS OR TRIBE/ANC
     198      209   INCALPER   FULL-YEAR WEIGHT
     210      212   STRATUMX   SAMPLING STRATUM
     213      213   SPSU       PSEUDO PSU


NMES DENTAL VISIT CODEBOOK

 Starting Numbers 1-59
                         NMES DENTAL VISIT CODEBOOK
                          DATE:     MARCH 26, 1992
                          ________________________

 This codebook provides unweighted and weighted frequencies for the use of
 dental services for calendar year 1987.  The data file contains one record
 per dental visit for each person in the Household Survey who reported having
 received dental care over the course of 1987.  Basic demographic information
 about each user, the type of service, associated expenses, sources of
 payments, and diagnoses are also included on each record. To obtain national
 estimates for the variables on this file, the weight described at the end of
 this codebook must be used.  Information concerning sample design and
 variance estimation is provided in the file documentation. For variables
 corresponding directly to questionnaire items, the item number is provided
 in the variable descriptor, which also identifies edited variables.  For
 variables with an asterisk in the rightmost column, explanatory notes are
 provided at the end of the codebook in alphabetical order of the variable
 name.

 NAME       DESCRIPTION                        FORMAT  TYPE  START   END NOTE
 ----       -----------                        ------  ----  -----   --- ----
 ODUX       ORIGINAL DWELLING UNIT OF PERSON       5.0   NUM      1      5
                     VALUE            UNWEIGHTED     WEIGHTED BY INCALPER
                     20001-37615          38,429              291,766,756
                     TOTAL                38,429              291,766,756

 PN         PERSON NUMBER                     3.0   NUM      6      8
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              10-266                       38,429              291,766,756
              TOTAL                        38,429              291,766,756

 EN         EVENT NUMBER                           4.0   NUM      9     12
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               11-1209                      38,429              291,766,756
               TOTAL                        38,429              291,766,756

 RVISN      VISIT NUMBER                           2.0   NUM     13     14
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               0-99                         38,429              291,766,756
               TOTAL                        38,429              291,766,756

 PIDX       PERSON NUMBER (ODUX + PN)              8.0  CHAR     15     22
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               VALID PERSON ID              38,429              291,766,756
               TOTAL                        38,429              291,766,756

 EVENTIDX   EVENT ID (ODUX + PN + EN)              12.0  CHAR     23     34
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               VALID EVENT ID               38,429              291,766,756
               TOTAL                        38,429              291,766,756

 VISITIDX   VISIT ID (ODUX + PN + EN + RVISN)     14.0  CHAR     35     48
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               VALID VISIT ID               38,429              291,766,756
               TOTAL                        38,429              291,766,756

 ROUND      DATA COLLECTION ROUND                    2.0   NUM     49     50
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               -9 NOT ASCERTAIN                394                2,982,583
                1                            9,893               74,974,544
                2                           14,201              108,329,469
                3                            8,815               66,870,010
                4                            5,126               38,610,150
               TOTAL                        38,429              291,766,756

 LASTAGE    ED PID AGE AT END OF LAST ELIGIBLE ROUND   3.0   NUM   51     53
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               0-17                         9,956               76,002,104
              18-44                        14,009              117,410,559
              45-64                         7,749               64,536,903
              65+                           6,715               33,817,191
              TOTAL                        38,429              291,766,756

 SMPSEXR    PID SEX                               1.0   NUM     54     54
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               1 MALE                       16,126              125,944,697
               2 FEMALE                     22,303              165,822,060
               TOTAL                        38,429              291,766,756

 RACE6      ED PID RACE                        1.0   NUM     55     55       *
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              1 AMER INDIAN                   170                1,405,352
              2 ALASKAN NATIVE                 35                  265,146
              3 ASIAN/PACIFIC                 530                4,667,745
              4 BLACK                       4,934               17,967,064
              5 WHITE                      31,893              262,764,079
              6 OTHER                         867                4,697,371
              TOTAL                        38,429              291,766,756

 RACE3      PID RACE/ETHNICITY                   1.0   NUM     56     56
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              1 HISPANIC                    2,653               12,831,723
              2 BLACK NONHISP               4,872               17,671,554
              3 OTHER                      30,904              261,263,479
              TOTAL                        38,429              291,766,756

 SREGION    PID CENSUS REGION                  1.0   NUM     57     57
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               1 NORTHEAST                   8,900               70,703,291
               2 MIDWEST                     9,783               77,334,827
               3 SOUTH                      11,416               82,255,720
               4 WEST                        8,330               61,472,917
               TOTAL                        38,429              291,766,756

 DNDATEMM   D1 DATE OF DENTAL VISIT - MONTH          2.0   NUM     58     59
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              -9 NOT ASCERTAIN                103                  640,125
              -8 DON'T KNOW                   182                1,152,580
              -7 REFUSED                        1                    5,007
              -5 NEVER KNOW                    73                  525,504
               1 JANUARY                    3,537               26,157,190
               2 FEBRUARY                   3,616               27,345,912
               3 MARCH                      3,662               27,885,300
               4 APRIL                      3,251               24,878,832
               5 MAY                        3,058               23,223,621
               6 JUNE                       3,555               27,499,550
               7 JULY                       3,019               23,005,022
               8 AUGUST                     2,946               22,535,688
               9 SEPTEMBER                  2,741               21,012,908
              10 OCTOBER                    3,217               24,739,829
              11 NOVEMBER                   2,830               21,225,706
              12 DECEMBER                   2,638               19,933,983
              TOTAL                        38,429              291,766,756

 Starting Numbers 60-79
  NAME      DESCRIPTION                        FORMAT  TYPE  START   END NOTE
  ----      -----------                        ------  ----  -----   --- ----
 DNDATEDD   D1 DATE OF DENTAL VISIT - DAY         2.0   NUM     60     61
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               -9 NOT ASCERTAIN                400                2,862,567
               -8 DON'T KNOW                 2,065               14,569,772
               -7 REFUSED                        4                   14,540
               -5 NEVER KNOW                   700                5,128,717
                  1-31                      35,260              269,191,160
               TOTAL                        38,429              291,766,756

 DNDATEYY   D1 DATE OF DENTAL VISIT - YEAR          2.0   NUM     62     63
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              87                           38,429              291,766,756
              TOTAL                        38,429              291,766,756

 PROVCOD    D2 SPECIALTY OF PROVIDER                2.0   NUM     64     65
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              -9 NOT ASCERTAIN                880                6,398,601
              -8 DON'T KNOW                    77                  435,538
              -7 REFUSED                       13                   95,642
              -1 INAPPLICABLE                 938                5,852,717
               2 ANESTHESIOLGY                 53                  362,533
               4 DERMATOLOGY                    6                   49,924
               5 FAMLY PRCTICE                 20                  152,278
               6 GENRL PRCTICE                 64                  579,762
               7 INTERNL MEDCN                 27                  209,994
               8 OB/GYN                         8                   39,262
               9 OPHTHALMOLOGY                 36                  250,290
              10 ORTHOEPY                     149                1,123,835
              11 OSTEOPATHY                    25                  134,400
              12 OTOLARYNGOLGY                  8                   90,014
              14 PEDIATRICS                    30                  207,420
              17 SURGERY                      122                  904,414
              18 UROLOGY                        3                   21,207
              19 DENTIST/CLNIC             35,763              273,527,142
              20 EM ROOM PHYSN                  7                   56,525
              21 NEUROLOGIST                    1                    5,645
              24 GASTRENTERLGY                  1                    4,469
              52 CHIROPRACTOR                   5                   48,261
              55 NURSE                         43                  293,578
              56 NURSE PRACTNR                  4                   20,803
              57 TECHNICIAN                    10                   53,532
              59 OPTOMETRIST                   28                  190,834
              60 PODIATRIST                     4                   16,629
              61 PHYSCIAN ASST                 12                   45,324
              63 PSYCHOLOGIST                   1                    3,703
              65 SOCIAL WORKER                  1                    3,314
              66 SPEECH THRPST                  1                    6,464
              91 OTH DR SPECL                  60                  366,287
              92 OTH PROVIDER                  29                  216,417
              TOTAL                        38,429              291,766,756

 FACTYPE    D2 TYPE OF DENTAL FACILITY           2.0   NUM     66     67
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              -9 NOT ASCERTAIN              1,449               10,407,377
              -8 DON'T KNOW                    27                  165,376
              -7 REFUSED                        6                   73,566
              -1 INAPPLICABLE              32,076              248,107,579
               1 DR OFFICE/GRP                 79                  566,505
               2 DR CLINIC                     44                  342,135
               3 NEIGH/FAM CTR                 97                  429,650
               4 SURGICAL CNTR                  5                   22,368
               5 COMPANY CLNIC                 12                   70,733
               6 SCHOOL CLINIC                 24                  119,667
               7 OTHER CLINIC                 232                1,309,707
               9 LABORATORY                    10                   39,779
              10 WLK-IN URGENT                  7                   63,270
              11 HOSP CLNIC/ER                319                2,011,725
              19 DENTAL CLINIC              3,888               27,053,973
              22 OPTICAL STORE                  7                   33,559
              91 OTHER                        147                  949,786
              TOTAL                        38,429              291,766,756

 DENTVA     D3 DENTAL CLINIC IS A FACILITY OF THE VA  2.0   NUM   68     69
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               -9 NOT ASCERTAIN                478                3,812,946
               -8 DON'T KNOW                     3                   11,057
               -1 INAPPLICABLE              33,836              255,773,423
                1 YES                          126                  805,886
                2 NO                         3,986               31,363,445
               TOTAL                        38,429              291,766,756

 DENTINJ    D4 DENTAL VISIT DUE TO ACCIDENT/INJURY    2.0   NUM     70     71
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               -9 NOT ASCERTAIN                338                2,432,155
               -8 DON'T KNOW                    63                  513,711
                1 YES                          802                5,935,260
                2 NO                        37,226              282,885,630
               TOTAL                        38,429              291,766,756

 ICD1       D5 ICD9 CODE - CONDITION 1            4.0  CHAR     72     75
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              -1 INAPPLICABLE              37,627              285,831,497
              -9 NOT ASCERTAIN                 31                  219,377
                 V001-V999                     67                  470,509
                 X00X-X999                      7                   67,932
                 0001-9999                    697                5,177,441
              TOTAL                        38,429              291,766,756

 ICD2       D5 ICD9 CODE - CONDITION 2            4.0  CHAR     76     79
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              -1 INAPPLICABLE              38,387              291,435,763
              -9 NOT ASCERTAIN                 31                  219,377
                 0001-9999                     11                  111,617
              TOTAL                        38,429              291,766,756

 Starting Numbers 80-101

 NAME      DESCRIPTION                        FORMAT  TYPE  START   END NOTE
 ----      -----------                        ------  ----  -----   --- ----
 DENTXRAY   D6 X-RAY THIS VISIT                   2.0   NUM     80     81
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              -9 NOT ASCERTAIN                336                2,351,768
              -8 DON'T KNOW                   291                2,339,697
              -7 REFUSED                        1                    5,007
               1 YES                       13,251              100,067,715
               2 NO                        24,550              187,002,570
              TOTAL                        38,429              291,766,756

 JUSTXRAY   D7 ONLY X-RAY THIS VISIT               2.0   NUM     82     83
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               -9 NOT ASCERTAIN                 73                  514,758
               -8 DON'T KNOW                    29                  173,818
               -7 REFUSED                        5                   16,933
                1 YES                          860                6,088,456
                2 NO                        37,462              284,972,791
               TOTAL                        38,429              291,766,756

 CLENTETH   D7 TEETH CLEANED THIS VISIT             2.0   NUM     84     85
             VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
             -9 NOT ASCERTAIN                 59                  378,103
             -8 DON'T KNOW                    26                  154,700
             -7 REFUSED                        5                   16,933
             -1 INAPPLICABLE                 853                6,047,569
              1 YES                       13,079              102,374,424
              2 NO                        24,407              182,795,027
             TOTAL                        38,429              291,766,756

 EXAMINE    D7 EXAMINATION THIS VISIT              2.0   NUM     86     87
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              -9 NOT ASCERTAIN                 56                  376,286
              -8 DON'T KNOW                    27                  170,742
              -7 REFUSED                        5                   16,933
              -1 INAPPLICABLE                 853                6,047,569
               1 YES                       11,375               88,747,433
               2 NO                        26,113              196,407,793
              TOTAL                        38,429              291,766,756

 ORTHDONT   D7 ORTHODONTIA THIS VISIT              2.0   NUM     88     89
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              -9 NOT ASCERTAIN                 65                  484,607
              -8 DON'T KNOW                    28                  173,121
              -7 REFUSED                        5                   16,933
              -1 INAPPLICABLE                 853                6,047,569
               1 YES                        4,886               39,153,609
               2 NO                        32,592              245,890,916
              TOTAL                        38,429              291,766,756

 FILLING    D7 FILLING(S) THIS VISIT               2.0   NUM     90     91
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              -9 NOT ASCERTAIN                 63                  422,521
              -8 DON'T KNOW                    20                  151,725
              -7 REFUSED                        5                   16,933
              -1 INAPPLICABLE                 853                6,047,569
               1 YES                        6,463               48,727,599
               2 NO                        31,025              236,400,409
              TOTAL                        38,429              291,766,756

 EXTRACT    D7 EXTRACTION(S) THIS VISIT           2.0   NUM     92     93
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              -9 NOT ASCERTAIN                 70                  472,343
              -8 DON'T KNOW                    24                  156,300
              -7 REFUSED                        5                   16,933
              -1 INAPPLICABLE                 853                6,047,569
               1 YES                        3,048               19,944,424
               2 NO                        34,429              265,129,187
              TOTAL                        38,429              291,766,756

 ROOTCANL   D7 ROOT CANAL(S) THIS VISIT             2.0   NUM     94     95
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              -9 NOT ASCERTAIN                 72                  500,804
              -8 DON'T KNOW                    25                  151,936
              -7 REFUSED                        5                   16,933
              -1 INAPPLICABLE                 853                6,047,569
               1 YES                        1,745               12,636,058
               2 NO                        35,729              272,413,455
              TOTAL                        38,429              291,766,756

 CROWNS     D7 CROWN(S) THIS VISIT                 2.0   NUM     96     97
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               -9 NOT ASCERTAIN                 70                  464,662
               -8 DON'T KNOW                    27                  176,131
               -7 REFUSED                        5                   16,933
               -1 INAPPLICABLE                 853                6,047,569
                1 YES                        2,372               18,944,336
                2 NO                        35,102              266,117,125
               TOTAL                        38,429              291,766,756

 BRIDGES    D7 BRIDGEWORK THIS VISIT               2.0   NUM     98     99
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              -9 NOT ASCERTAIN                 66                  440,879
              -8 DON'T KNOW                    29                  185,449
              -7 REFUSED                        4                   11,926
              -1 INAPPLICABLE                 853                6,047,569
               1 YES                          935                6,571,647
               2 NO                        36,542              278,509,286
              TOTAL                        38,429              291,766,756

 DENTURES   D7 DENTURES THIS VISIT                  2.0   NUM    100    101
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               -9 NOT ASCERTAIN                 72                  496,966
               -8 DON'T KNOW                    29                  185,449
               -7 REFUSED                        5                   16,933
               -1 INAPPLICABLE                 853                6,047,569
                1 YES                        1,436                8,734,345
                2 NO                        36,034              276,285,493
               TOTAL                        38,429              291,766,756

 Starting Numbers 102-138

 NAME      DESCRIPTION                        FORMAT  TYPE  START   END NOTE
 ----      -----------                        ------  ----  -----   --- ----
 REPAIR     D7 BRIDGE/DENTURE REPAIR THIS VISIT   2.0   NUM    102    103
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              -9 NOT ASCERTAIN                 71                  481,722
              -8 DON'T KNOW                    29                  185,449
              -7 REFUSED                        1                    5,007
              -1 INAPPLICABLE                 853                6,047,569
               1 YES                        1,345                8,677,698
               2 NO                        36,130              276,369,311
              TOTAL                        38,429              291,766,756

 DENTOTHR   D7 OTHER DENTAL WORK THIS VISIT          2.0   NUM    104    105
             VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
             -9 NOT ASCERTAIN                 72                  488,853
             -8 DON'T KNOW                    85                  585,628
             -7 REFUSED                        5                   16,933
             -1 INAPPLICABLE                 852                6,038,678
              0 NO                        33,176              251,532,288
             12 PERIODONTAL                  818                6,223,316
             13 FLUORIDE TRMT                623                5,237,174
             14 XRAYS IN COMB                 58                  477,319
             15 SEALANT                      173                1,462,143
             16 CAPPING                      246                2,026,086
             17 ORAL SURGERY                 423                3,029,230
             18 CONSULTATION                 168                1,392,324
             19 ABSCESS                       99                  740,940
             91 OTHER                      1,631               12,515,845
             TOTAL                        38,429              291,766,756

 TYPESRVX   ED TYPE OF DENTAL SERVICE                2.0   NUM    106    107
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               1 ONLY XRAY                    859                6,079,564
               2 TEETH CLEANED              4,952               37,678,629
               3 EXAMINATION                3,014               22,524,437
               4 ORTHODONTIA                4,526               36,499,468
               5 FILLING                    4,355               33,229,224
               6 EXTRACTION                 2,079               13,940,590
               7 ROOT CANAL                 1,118                8,153,676
               8 CROWNS                     1,563               12,830,217
               9 BRIDGES                      508                3,755,106
              10 DENTURES                   1,009                6,147,197
              11 REPAIR                       977                6,172,398
              12 OTHER DENTAL               2,456               19,020,107
              13 MULT SERVCS-1              1,818               13,055,965
              14 MULT SERVCS-2                864                5,838,200
              15 MULT SERVCS-3              8,331               66,841,980
              TOTAL                        38,429              291,766,756

 EXPTOT     D11 ORIGINAL TOTAL DENTAL CHARGE         7.2   NUM    108    114
             VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
             -9 NOT ASCERTAIN                210                1,373,444
             -8 DON'T KNOW                 1,803               13,285,929
             -7 REFUSED                        2                   19,815
             -5 NEVER KNOW                   809                6,020,559
             -1 INAPPLICABLE              15,021              110,645,241
                1.00-   5                    125                  834,654
                5.01-  50                 12,936              100,078,110
               50.01- 100                  4,683               37,372,483
              100.01- 200                  1,396               10,725,489
              200.01- 400                    889                7,045,225
              400.01- 600                    306                2,402,582
              600.01- 800                     93                  734,470
              800.01-1000                     57                  486,207
             1000.01-2000                     73                  595,439
             2000.01-6000                     26                  147,108
             TOTAL                        38,429              291,766,756

 EXPTOTX    EDITED TOTAL DENTAL EXPENSE            7.2   NUM    115    121
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
                 1.00-   5                    131                  928,598
                 5.01-  50                 19,527              145,122,550
                50.01- 100                  8,762               67,189,951
               100.01- 200                  5,389               42,506,122
               200.01- 400                  3,235               25,268,172
               400.01- 600                    845                6,749,847
               600.01- 800                    256                1,792,987
               800.01-1000                    112                  956,810
              1000.01-2000                    161                1,171,464
              2000.01-6000                     11                   80,255
              TOTAL                        38,429              291,766,756

 EXPTFLG    IMPUTATION FLAG FOR EDITED TOTAL EXPENSE  1.0   NUM    122    122
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              1 EXP FROM HS                29,289              228,450,873
              3 EXP IMPUTED                 9,140               63,315,884
              TOTAL                        38,429              291,766,756

 SOPTSELF   PCT PAYMENT FROM SELF OR FAMILY        8.4   NUM    123    130
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              0                             9,770               71,933,026
              GT 0 TO 20                    3,762               31,129,235
              GT 20 TO 40                   2,142               17,495,694
              GT 40 TO 60                   2,425               20,309,690
              GT 60 TO 80                   1,133                9,716,584
              GT 80 TO LT 100                 522                4,011,415
              100                          18,675              137,171,111
              TOTAL                        38,429              291,766,756

 SOPTPRVT   PCT PAYMENT FROM PRIVATE INSURANCE       8.4   NUM    131    138
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               0                            24,055              172,434,469
               GT 0 TO 20                      557                4,257,959
               GT 20 TO 40                   1,053                9,108,283
               GT 40 TO 60                   2,387               20,186,425
               GT 60 TO 80                   3,514               28,926,623
               GT 80 TO LT 100               1,743               15,035,985
               100                           5,120               41,817,012
               TOTAL                        38,429              291,766,756

 Starting Numbers 139-213

 NAME      DESCRIPTION                        FORMAT  TYPE  START   END NOTE
 ----      -----------                        ------  ----  -----   --- ----
 SOPTMCR    PCT PAYMENT FROM MEDICARE             8.4   NUM    139    146
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              0                            38,360              291,489,903
              GT 20 TO 40                       3                   13,247
              GT 40 TO 60                      21                   86,140
              GT 60 TO 80                       4                   19,179
              100                              41                  158,287
              TOTAL                        38,429              291,766,756

 SOPTMCD    PCT PAYMENT FROM MEDICAID              8.4   NUM    147    154
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              0                            36,462              281,185,033
              GT 0 TO 20                        5                   18,338
              GT 20 TO 40                       4                   10,233
              GT 40 TO 60                       7                   42,634
              GT 60 TO 80                      16                   51,572
              GT 80 TO LT 100                 214                1,109,077
              100                           1,721                9,349,870
              TOTAL                        38,429              291,766,756

 SOPTOTFD   PCT PAYMENT FROM OTHER FEDERAL          8.4   NUM    155    162
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              0                            37,858              288,160,425
              GT 0 TO 20                       12                   71,706
              GT 20 TO 40                       2                   16,744
              GT 40 TO 60                       3                   17,992
              GT 60 TO 80                      15                  119,817
              GT 80 TO LT 100                   5                   39,455
              100                             534                3,340,619
              TOTAL                        38,429              291,766,756

 SOPTOTST   PCT PAYMENT FROM OTHER STATE            8.4   NUM    163    170
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              0                            38,253              290,856,797
              GT 0 TO 20                        1                    9,652
              GT 40 TO 60                       3                   36,805
              GT 60 TO 80                       4                   21,403
              GT 80 TO LT 100                  13                   74,506
              100                             155                  767,594
              TOTAL                        38,429              291,766,756

 SOPTWC     PCT PAYMENT FROM WORKERS COMP          8.4   NUM    171    178
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               0                            38,391              291,420,221
               GT 0 TO 20                        3                   30,612
               GT 80 TO LT 100                   1                    9,140
               100                              34                  306,784
               TOTAL                        38,429              291,766,756

 SOPTOTHR   PCT PAYMENT FROM OTHER                  8.4   NUM    179    186
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              0                            38,042              288,570,242
              GT 0 TO 20                       90                  730,624
              GT 20 TO 40                      12                  124,632
              GT 40 TO 60                      44                  414,352
              GT 60 TO 80                      69                  642,935
              GT 80 TO LT 100                  59                  459,649
              100                             113                  824,323
              TOTAL                        38,429              291,766,756

 SOPTFFP    PCT PAYMENT FREE FROM PROVIDER          8.4   NUM    187    194
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               0                            36,147              274,505,520
               GT 0 TO 20                       19                  182,196
               GT 20 TO 40                     132                1,165,547
               GT 40 TO 60                      34                  308,988
               GT 60 TO 80                      40                  283,538
               GT 80 TO LT 100                  23                  128,735
               100                           2,034               15,192,232
               TOTAL                        38,429              291,766,756

 SOPTFLG    IMPUTATION FLG FOR SOURCE OF PAYMENT      1.0   NUM    195    195
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              1 ALL SOP FRM HS             32,283              244,125,376
              2 ALL SOP IMPUTD              6,146               47,641,380
              TOTAL                        38,429              291,766,756

 IHSFAC     D31 DENTAL FACILITY IHS OR TRIBE/ANC     2.0   NUM    196    197
              VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
              -9 NOT ASCERTAIN                186                1,409,282
              -1 INAPPLICABLE              38,153              289,595,359
              1 IHS                            13                  110,573
              3 NOT IHS/TRIBE                  77                  651,543
              TOTAL                        38,429              291,766,756

 INCALPER   FULL-YEAR WEIGHT                      12.6   NUM    198    209
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               780.924-27174.39             38,429                     N/A
               TOTAL                        38,429                     N/A

 STRATUMX   SAMPLING STRATUM                        3.0   NUM    210    212
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               301-401                      38,429              291,766,756
               TOTAL                        38,429              291,766,756

 SPSU       PSEUDO PSU                             1.0   NUM    213    213
               VALUE                    UNWEIGHTED     WEIGHTED BY INCALPER
               1                            18,985              144,146,986
               2                            19,444              147,619,771
               TOTAL                        38,429              291,766,756


NMES HOUSEHOLD SURVEY DENTAL VISIT CODEBOOK NOTES

     An asterisk in the rightmost column of the codebook indicates that
     an explanatory note provides greater detail on information
     necessary for the use of this variable.  These notes are listed
     below in alphabetical order of variable name.

     VARIABLE                           NOTE

     DENTOTHR       A constructed variable that was created by
                    reviewing the "other, specify" text field for the
                    question on type of dental services provided (D7).
                    Possible positive values are:
                    12   Periodontal work
                    13   Fluoride treatment
                    14   X-rays in combination with other
                         work
                    15   Sealant applied
                    16   Tooth capped
                    17   Oral surgery
                    18   Consultation
                    19   Abscess
                    91   Other work

     EN             These variables identify and link multiple or
     RVISN          repeat dental visits.  VISITIDX is the unique
     VISITIDX       record identifier for each dental visit.  The event
                    number, EN, identifies an initial contact with a
                    given provider for specific services during a
                    round.  RVISN is the numerical identifier for any
                    repeat visits within one data collection round to
                    the same provider for the same services at the same
                    expense.  Here, RVISN for the first visit equals
                    zero and all repeat visits associated with that
                    visit are numbered consecutively (RVISN = 1 to n).
                    The first visit and all repeat visits share the
                    same event number.

     EXPTFLG        A flag indicating whether the total expense for
                    that visit record was imputed or provided by the
                    household respondent.

     EXPTOT         Unedited charge (EXPTOT) and edited expenditure
     EXPTOTX        (EXPTOTX) variables reflecting total expense for
                    each dental visit by the sample person during 1987.
                    A dollar value was assigned to the edited expense
                    variable for all dental visits, including those
                    free from provider and those financed through a
                    prepaid capitation (HMO) payment.

     FACTYPE        Variable containing the type of dental
     PROVCOD        professional (PROVCOD) or facility (FACTYPE)
                    providing dental services as reported by the
                    household respondent.  These data were collected as
                    part of Question D 2.  Persons could have provided
                    both the type of provider and the facility.  In
                    cases where only facility data were collected,
                    PROVCOD is coded -1.  In cases where only the type
                    of dental professional was collected, FACTYPE is
                    coded -1.  Neither FACTYPE nor PROVCOD were edited
                    for consistency or imputed.

     INCALPER       Weight adjusted for nonresponse and post-stratified
                    to U.S. census data.  Estimates of utilization and
                    expenditure for dental visits require the use of
                    weighted data.  For details on this weight, see the
                    Technical and Programming section on this file and
                    the hard copy documentation accompanying this tape.

     LASTAGE        An edited variable which identifies person age, in
                    years, as of the end of the last round in 1987 for
                    which the person was eligible.  Less than 0.1
                    percent of the cases were edited.

     PROVCOD        See FACTYPE.

     RACE3          A person-level variable constructed to facilitate
                    the poststratification of the NMES person-level
                    sampling weights by race and ethnicity, considering
                    three mutually exclusive classifications:
                    Hispanic, Black--non-Hispanic, and white or other.

     RACE6          An edited variable indicating race.  Less than 0.2
                    percent of cases were edited.

     ROUND          Indicator of the round of data collection.  Dates
                    for each sample person's rounds of data collection
                    are provided on NMES Public Use Tape 13.

     RVISN          See EN.

     SOPTFLG        A flag indicating whether all the source of payment
                    percentages for that dental record were imputed or
                    provided by the household respondent.

     SPSU           To obtain variance estimates of sample statistics
     STRATUMX       by means of standard statistical programs that use
                    the Taylor series linearization method of variance
                    estimation, variables must be used that denote the
                    strata and primary sampling unit (PSU) within a
                    given strata.  The variables STRATUMX and SPSU are
                    these variables, respectively.  For details on
                    sampling weights and variance estimation, see the
                    Technical and Programming section on this file and
                    the hard copy documentation accompanying this tape.



     TYPESRVX       An edited variable indicating the type of service
                    provided during the visit.  Variable values are:

                    1    X-rays only

                    2    Teeth cleaned

                    3    Dental examination

                    4    Orthodontia work

                    5    Filling

                    6    Tooth extraction

                    7    Root canal work

                    8    Crown work

                    9    Bridgework

                   10    Denture work during the visit

                   11    Repair of dental work during the visit.

                   12    Dental work involving at least one
                         other type of service.

                   13    Multiple services-1: at least two specific
                         types of service in which at least one was
                         work on a root canal, crown, bridge, or
                         dentures and none were other services.  For
                         example, a dental visit with a crown and a
                         filling would be included in this group.

                   14    Multiple services-2: visits with at least one
                         orthodontic service or extraction, but no root
                         canal, crown, bridge, denture work, or other
                         services.

                   15    Multiple services-3: dental visits with at
                         least two specified types of service, none of
                         which were an extraction, orthodontia, or root
                         canal, crown, bridge, or denture work or other
                         service.  A visit involving a filling and an
                         x-ray is an example of multiple services-3.

     VISITIDX            See EN.




This page last reviewed: Thursday, January 28, 2016
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