Enhancing the representation of rural areas in the National Medical Expenditure Survey.

This study examines the issues associated with enhancing the representation of rural areas in the National Medical Expenditure Survey (NMES). It reviews alternative definitions of rural areas and describes the classification schemes considered for future cycles of the NMES. A review of the NMES sample representation in rural areas and an examination of the analytical capabilities and limitations of the current design for deriving health care estimates of the rural population is provided. The options presented in this article would extend the analytical capacity of the NMES to permit estimates of rural areas of the national classified by census region, by gradations of rural classification, and for individuals residing in rural frontier counties.