Sixth Conference (1995)

Library of Congress Cataloging-in-Publication Data Conference on Health Survey Research Methods (6th : 1995 : Breckenridge, Colo,) Health survey research methods conference proceedings/ edited by Richard Warnecke. p. cm. — (DHHS publication ; no. (PHS) 96-1013) “April 1996.” Includes bibliographical references. 1. Health surveys-Congresses. I Warnecke, Richard B. Il. Title, Ill. Series. RA408.5.C58 1995 614.4’2--dc20 96-13418 CIP National Center for Health Statistics Jack R. Anderson, Acting Director Jennifer H. Madans, Ph.D., Acting Deputy Director Jacob J. Feldman, Ph.D., Associate Director for Analysis, Epidemiology, and Health Promotion Gail F. Fisher, Ph.D., Associate Director for Planning and Extramural Programs Jack R. Anderson, Acting Associate Director for International Statistics Stephen E. Nieberding, Associate Director for Management Charles J. Rothwell, Associate Director for Data Processing and Services Monroe G. Sirken, Ph.D., Associate Director for Research and Methodology Foreword These are the proceedings of the Sixth Conference on in health survey research methods convened in conference Health Survey Research Methods, held in Breckenridge, at Airlie House in Airlie, Virginia. The agenda was a Colorado, June 24–26, 1995. As in the past, this conference discussion of how best to provide a venue for the discussion moved ahead on the continuum of methodological improve- of the results of methodological research in health surveys ments, adding to what is known and addressing new areas from which they could be communicated to the large body that had been featured briefly at previous conferences. The of researchers engaged in the broad areas of health services long-range objectives of this conference, as of its predeces- research and epidemiology. The specific goals of that first sors, were to improve the quality of health survey data and meeting were to to enhance their value and use by policy makers responsible 1. identify critical methodological issues or problem for shaping health practice, policy, and programs. The areas for health survey research and the state of the immediate aims of this, the Sixth Conference on Health art or knowledge with respect to these problems; Survey Research Methods, followed those of predecessor conferences and were to 2. define the types of research problems that needed priority funding; 1. invite formal presentation on the state of the art in defined areas of survey methodology as it relates to the 3. identify policy issues that could be addressed by quality of data on the nation's health; survey data; and 2. promote discussion of these presentations using a 4. communicate the results, recommendations, and format combining formal discussion of each presenta- implications to (a) the broader community of health tion with open discussion and comments from all researchers who use survey methods, (b) relevant conference participants; government agencies and policy makers, and (c) other 3. prepare a written summary of the discussion compiled potential users of survey data. from the formal papers, invited discussion, and open The conclusions of this initial conference reemphasized discussion in the form of conference proceedings; and the need for ongoing discussion about health survey 4. publish and disseminate the proceedings as a timely research methods—in particular, what defined the state of statement about the current understanding of the the art and what did not work. To stress the need for sources of nonsampling survey error, new knowledge continuity over time, Leo Reeder concluded the introduction of ways to reduce this error, and required research by stating that the first proceedings was "tentatively planned relevant to health surveys. as Volume 1," in the hope that "conferences and reports In all, 65 persons attended this conference. Twenty-nine such as this [would] occur on a biennial or triennial basis." papers were selected from 150 submissions. The selected These first proceedings stressed the importance of these papers were divided into five sessions: "Measuring Medical conferences for facilitating communication among research- Care and Health Status" (six papers), "Research on Survey ers who use, develop, or evaluate survey methods but who Questions" (six papers), "Sampling and Cooperation" (six are dispersed both geographically and in their work settings. papers), "Special Populations and Sensitive Issues" (six They pointed to the fact that there was no other specific papers), and "Integrating Surveys and Other Data" (five venue for convening those with interests in health survey papers). A chairperson and rapporteur were assigned to research for discussion of common interests and problems each session, and there were two formal discussants encountered in their work in the specific area of applica - persession. tion, health survey research methods. Finally, they stressed the need for working conferences that would allow for discussion of work in progress, negative results, and other Background and History of the Health topics that were not ordinarily addressed in the usual Survey Research Methods Conferences journals or meetings. The second and third conferences were held at 2-year In 1975, led by Leo Reeder, a group of over 50 method- intervals in 1977 and 1979. At each conference, the agenda ologists and substantive researchers with common interests and presentation format became more specific. By the 1979 iii conference, papers describing specific projects with re- specific themes have varied from conference to conference. sponses by discussants had supplanted the general thematic For example, all the conferences but the present one had a discussion that comprised the programs at the first two specific session addressing the issue of total survey design. conferences. However, the key aspects of these conferences All six conferences have addressed issues of validity of did not change: They remained by invitation only, the survey data both in independent sessions and through papers were meant to guide general discussion, and the consideration of questionnaire design, respondent recall and important role of the rapporteur at each conference in burden, and validation of survey responses through records. capturing and recording the general discussion that followed Most have had a session on sample design and locating rare the formal presentations was retained. It is a unique aspect populations or hard-to-contact respondents. At each confer- of these proceedings that the general discussion is always ence, there has also been a session on mode of data collec- written up and included as part of the publication. More- tion. over, the summary of the discussion for each session is How these general themes were addressed at each generally considered to be as important as the formal conference was affected by the major policy issues for presentations. which the data were needed at the time of each conference. The fourth conference was held in 1982, 3 years after the In 1979, the government was beginning to collect data on third conference. Seven years elapsed between the fourth access to and costs of various elements of health care. The conference and the fifth conference, which took place in major themes in the Third Conference on Health Survey 1989. The present conference occurred 6 years after the Research Methods reflected those policy objectives. Most fifth. The longer time intervals between the last three of the paper sessions and several special sessions in the conferences as compared with the first three reflect the program addressed the design and implementation of major growing difficulty in finding adequate support to fund the surveys designed to assess the costs of health care and conferences. Until the present conference, support came access by the population to health care services. General almost entirely from the National Center for Health Ser- sessions contained papers on the design of the National vices Research (later the National Center for Health Ser- Ambulatory Medical Care Survey and the National Medical vices Research and Health Care Technology Assessment Care Expenditure Survey (NMCES). There were also and now the Agency for Health Care Policy and Research special sessions during which the recommendations of the [AHCPR]) and the National Center for Health Statistics Technical Consultant Panel for the redesign of the National (NCHS). Over these years, the conferences received some Health Interview Survey and selected methodological ancillary support from Veteran's Affairs, the Milbank Me- features of the 1980 Census were presented. The agenda for morial Fund, and the Commonwealth Fund. However, by the fourth conference explored further methodological issues this sixth conference, a broad base of support from a vari- related to the NMCES and health surveys in other coun- ety of federal agencies and private foundations that make tries. use of survey data was needed to ensure the conference By the fifth conference, there had been a major shift of would be held. In addition to AHCPR, which supported the focus from access and costs of health care to the epidemiol- conference through a grant, and NCHS, which supported ogy of AIDS and how to measure seroprevalence. Although the conference and is publishing the proceedings, funding there were at least two papers addressed to issues of access for this conference came from the Robert Wood Johnson and costs, the theme of the fifth conference was the effects Foundation, National Institute on Alcohol Abuse and

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