Sampling coverage of the Arkansas all-payer claims database by County's persistent poverty designation

Area of Science:

• Health Services Research
• Health Equity
• Database Quality Assessment

Background:

• Persistent poverty areas often face unique health challenges and require robust data for research.
• Evaluating the representativeness of healthcare claims databases is crucial for accurate disparity research.

Purpose of the Study:

• To assess the Arkansas All-Payer Claims Database (APCD) quality for health disparity research.
• To determine APCD's representativeness of the Arkansas population, county-level variations, and coverage differences in persistent poverty areas.

Main Methods:

• Cross-sectional study utilizing 2019 Arkansas APCD member enrollment and county-level data.
• Analysis of three cohorts based on medical coverage duration (≥1 day, June, continuous).
• Comparison of sampling proportions between persistent poverty and other counties using inverse-variance weighted linear regression.

Main Results:

• In 2019, APCD covered 73.6% (Cohort 1), 66.3% (Cohort 2), and 58.8% (Cohort 3) of Arkansans.
• Coverage sampling proportions varied by county but were consistently higher in persistent poverty counties across all cohorts.
• County characteristics associated with higher coverage included larger size and higher proportions of females or individuals aged 65+.

Conclusions:

• The Arkansas APCD offers substantial coverage of the state's population.
• Healthcare coverage within the APCD is notably higher in persistent poverty counties compared to other areas.
• The APCD is a suitable resource for investigating health disparities in persistent poverty regions of Arkansas.