A potential new data source for assessing the impacts of health reform: Evaluating the Gallup-Healthways Well-Being Index

Abstract

Background: Existing national health-related surveys take several months or years to become available. The Affordable Care Act will bring rapid changes to the health care system in 2014. We analyzed the Gallup-Healthways׳ Well-Being Index (WBI) in order to assess its ability to provide real-time estimates of the impact of the ACA on key health-related outcomes.

Methods: We compared the Gallup-Healthways WBI to established surveys on demographics, health insurance, access to care, and health. Data sources were the Gallup-Healthways WBI, the Current Population Survey, the American Community Survey, the Medical Expenditure Panel Survey, the National Health Interview Survey, and the Behavioral Risk Factor Surveillance System. Demographic measures included age, race/ethnicity, education, and income. Insurance outcomes were coverage rates by type, state, and year. Access measures included having a usual source of care and experiencing cost-related delays in care. Health measures were self-reported health and history of specific diagnoses.

Results: Most differences across surveys were statistically significant (p<0.05) due to large sample sizes, so our analysis focused on the absolute magnitude of differences. The Gallup-Healthways WBI post-weighted sample was similar in age, race/ethnicity, and education to other surveys, though the Gallup-Healthways WBI sample is slightly older, has fewer minorities, and is more highly educated than in other national surveys. In addition, income was more frequently missing. The Gallup-Healthways WBI produced similar national, state, and time-trend estimates on uninsured rates, but far lower rates of public coverage. Access to care and health status were similar in the Gallup-Healthways WBI and other surveys.

Conclusions: The Gallup-Healthways WBI is a valuable complement to existing data sources for health services research. The Gallup-Healthways WBI estimates for uninsured rates and access to care were similar to established national surveys and may allow for rapid estimates of the ACA׳s impact on the uninsured in 2014. Estimates of insurance type are less comparable, particularly for public coverage, which likely limits the utility of the Gallup-Healthways WBI for analyzing changes in particular types of coverage.

Keywords: Access to care; Data sources; Health insurance; Health policy; Survey.