Accounting for study participants who are ineligible for linkage: a multiple imputation approach to analyzing the linked National Health and Nutrition Examination Survey and Centers for Medicare and Medicaid Services' Medicaid data

Data from the National Health and Nutrition Examination Survey have been linked to the Center for Medicare and Medicaid Services' Medicaid Enrollment and Claims Files for the survey years 1999-2004. The linked data are produced by the National Center for Health Statistics' (NCHS) Data Linkage Program and are available in the NCHS Research Data Center. This project compares the usefulness of multiple imputation to account for data linkage ineligibility and other survey nonresponse with currently recommended weight adjustment procedures. Estimated differences in environmental smoke exposure across Medicaid/Children's Health Insurance Program (CHIP) enrollment status among children ages 3-15 years are examined as a motivating example. Comparisons are drawn across the three different estimates: one that uses MI to impute the administrative Medicaid/CHIP status of those who are ineligible for linkage, a second that uses the linked data restricted to linkage eligible participants with a basic weight adjustment, and a third that uses self-reported Medicaid/CHIP status from the survey data. The results indicate that estimates from the multiple imputation analysis were comparable to those found when using weight adjustment procedures and had the added benefit of incorporating all survey participants (linkage eligible and linkage ineligible) into the analysis. We conclude that both multiple imputation and weight adjustment procedures can effectively account for survey participants who are ineligible for linkage.