Attachment 1 – MEPS-HC Section Summary and Changes
Summary of questionnaire sections and changes for the MEPS-HC since the previous OMB clearance. The sections are listed in alphabetical order, not the order which they occur in the instrument. All 42 sections of the current core instrument are available on the AHRQ website at http://meps.ahrq.gov/mepsweb/survey_comp/survey_questionnaires.jsp.
The MEPS-HC questionnaires for Rounds 1–5 consist of many individual sections. Listed below is a brief description of each section, including changes that have been made since the last OMB clearance.
Access to Care (AC)
This supplemental section, asked in Rounds 2 and 4, identifies whether each household member has a medical provider who provides the usual source of care (USC), reasons why members without a USC do not have a USC, various aspects of satisfaction with usual care providers, and problems a household may have experienced in obtaining needed health care. It also includes questions on possible language barriers to health care and specific problems any household member may have experienced in obtaining needed health, dental, or prescription medicine care.
Changes: None
Adult Self-Administered Questionnaire (Adult SAQ)
A brief self-administered questionnaire (SAQ) will be used to collect self-reported (rather than through household proxy) information on health status, health opinions and satisfaction with health care for adults 18 and older. The satisfaction with health care items are a subset of items from the Consumer Assessment of Healthcare Providers and Systems (CAHPS). The health status items are the Short Form 12 Version 2 (SF-12 version 2), which has been widely used as a measure of self-reported health status in the United States, the Kessler Index (K6) of non-specific psychological distress, and the Patient Health Questionnaire (PHQ-2)
Item |
Changes |
Year |
Text |
12 |
Question added. |
2010 |
|
2013 |
In the last 12 months, did a doctor or other health provider give you instructions about what to do about a specific illness or health condition? |
||
13 |
Question added. |
2010 |
|
2013 |
In the last 12 months, how often were these instructions easy to understand? |
||
14 |
Question added. |
2010 |
|
2013 |
In the last 12 months, how often did doctors or other health providers ask you to describe how you were going to follow these instructions? |
||
15 |
Question added. |
2010 |
|
2013 |
In the last 12 months, did you have to fill out or sign any forms at a doctor’s or other health provider’s office? |
||
16 |
Question added. |
2010 |
|
2013 |
In the last 12 months, how often were you offered help in filling out a form at the doctor’s or other health provider’s office? |
Assets (AS)
To supplement financial data collected in the Income section, the Assets supplemental section, asked in Round 5, asks about household members' real estate, businesses, vehicles, investments, other assets, and debts.
Item |
Changes |
Year |
Text |
AS04 |
Deleted phrase “That is, what would it sell for if sold today?” |
2010 |
About how much is the current value of this home? That is, what would it sell for if sold today? |
2013 |
About how much is the current value of this home if sold today? |
||
AS17 |
Simplified probe to “Anyone else?” |
2010 |
Who in the family has Individual Retirement Accounts (IRAs) or other retirement accounts (such as 401K, 403(b) or Keogh accounts)?
PROBE: Does anyone else in the family have these retirement accounts? |
2013 |
Who in the family has Individual Retirement Accounts (IRAs) or other retirement accounts (such as 401K, 403(b) or Keogh accounts)?
PROBE: Anyone else? |
||
AS21 |
Simplified probe to “Anyone else?” |
2010 |
Who in the family has bank accounts, including checking accounts, savings accounts, or money market accounts?
PROBE: Does anyone else in the family have bank accounts, including checking accounts, savings accounts, or money market accounts? |
2013 |
Who in the family has bank accounts, including checking accounts, savings accounts, or money market accounts?
PROBE: Anyone else? |
||
AS24 |
Simplified question text. |
2010 |
Now think about the approximate value of some other financial assets your family may own. Does anyone in the family have any of the following assets: certificates of deposit (CDs), government savings bonds, individual development accounts, treasury bills, bonds, bond mutual funds, shares of stock, stock mutual funds, education savings accounts, annuities, trusts to which they are beneficiaries, or other financial assets?
Please do not include any accounts or assets that we have already talked about. |
2013 |
Now think about the approximate value of some other financial assets your family may own. Please look at this card. Does anyone in the family have any of these assets?
Please do not include any accounts or assets that we have already talked about. |
||
AS28 |
Simplified question text. |
2010 |
Now please think about the approximate value of all other property and assets your family may own. Does anyone in the family have any of the following assets: second homes, rental real estate, a business or farm, money owed to you by persons outside of the family, boats or other recreational vehicles, or other significant assets such as jewelry, art work or antiques?
Please do not include any property or assets we have already talked about. |
2013 |
Now please think about the approximate value of all other property and assets your family may own. Please look at this card. Does anyone in the family have any of these assets?
Please do not include any property or assets we have already talked about. |
Calendar Section (CA)
This section monitors the use of a health events calendar provided to the respondent during the MEPS pre-contact interview for use in recording visits to medical providers and medical places. This information determines the household's path through the sections of the questionnaire that collect information on medical events.
Item |
Changes |
Year |
Text |
CA01 |
Simplified question text. |
2010 |
We've talked about health conditions for the family. The next set of questions is about health care received {in the last few months/between {START DATE OF REFERENCE PERIOD} and {END DATE OF REFERENCE PERIOD}}. Some of these questions ask for information which may be difficult to remember. Because it is important to the U.S. Public Health Service to get complete and accurate information, please take your time in answering these questions. |
2013 |
The next questions are about health care received {since {START DATE OF REFERENCE PERIOD}/between {START DATE OF REFERENCE PERIOD} and {END DATE OF REFERENCE PERIOD}}. Some of these questions ask for information which may be difficult to remember. It is important to get complete and accurate information, so please take your time and feel free to refer to any records you may have. |
||
CA02 |
Omitted first sentence, revised to clarify time frame. |
2010 |
We've talked about health conditions for the family. The next set of questions is about health care received {in the last few months/between {START DATE OF REFERENCE PERIOD} and {END DATE OF REFERENCE PERIOD}}. As you may remember from the last interview, some of these questions ask for information which may be difficult to remember. |
2013 |
The next questions are about health care received {since {START DATE OF REFERENCE PERIOD}/between {START DATE OF REFERENCE PERIOD} and {END DATE OF REFERENCE PERIOD}}. As you may remember from the last interview, some of these questions ask for information which may be difficult to remember. |
Charge Payment (CP)
The Charge Payment section tracks total charges and sources of payment for medical events reported in earlier sections. The section obtains specific information for each medical event reported on total charges, copayments, out-of-pocket payments, insurance payments, reimbursements, discounts, disallowed amounts, balance due, and other sources of payment. Additionally, it clarifies how prescription medicine claims are processed, including questions about third party payers for prescription medicines.
Item |
Changes |
Year |
Text |
CP12 |
Added description of “source” to question text. |
2010 |
Has any {other} source already paid for any of the charges for {this hospital stay/this visit/the last purchase of {NAME OF PRESCRIBED MEDICINE}/the services for (FLAT FEE GROUP)/the {OME ITEM GROUP NAME}/the services received at home}? |
2013 |
Has any {other} source already paid for any of the charges for {this hospital stay/this visit/the last purchase of {NAME OF PRESCRIBED MEDICINE}/the services for {FLAT FEE GROUP}/the {OME ITEM GROUP NAME}/the services received at home}?
By other source, we mean a private insurance company, an HMO, Medicare, Medicaid, or any other public program that may have paid. |
Child Preventive Health (CS)
This supplemental section, asked in Rounds 2 and 4, collects information on general health status, special health care needs, potential behavioral problems, accessibility to health care, preventative care, height, and weight of any child in the family.
Item |
Changes |
Year |
Text |
CS09A |
Omitted first sentence. |
2010 |
The following questions are about the health care (PERSON) received in the last 12 months.
In the last 12 months, did (PERSON) have an illness, injury or condition that needed care right away in a clinic, emergency room, or doctor’s office? |
2013 |
In the last 12 months, did {you/{PERSON}} have an illness, injury or condition that needed care right away in a clinic, emergency room, or doctor’s office? |
||
CS22 |
Omitted first sentence. |
2010 |
The following questions are about amounts and types of preventive care (PERSON) may receive when (he/she) goes to see a doctor or other health provider.
Has a doctor or other health provider ever measured (PERSON)’s height? |
2013 |
Has a doctor or other health provider ever measured {your/{PERSON}’s} height? |
Closing (CL)
At the end of each rounds interview, participants are asked to provide written authorization for the MEPS to collect additional information from the medical providers, insurance providers, and employers identified throughout each interview. The Closing section facilitates the completion of authorization forms for each unique person-provider pair and each unique person-establishment pair. During subsequent rounds of data collection, the MEPS-MPC and the MEPS-IC collect data on the medical visits and insurance coverage directly from medical providers and sources of insurance (e.g., employers) based on the authorization specified in these forms. This section also prompts the distribution of the Self Administered Questionnaire (SAQ) and Diabetes Care Survey (DCS). In addition, this section verifies the contact information for the household for use in the next interview and accounts for memory aids that were used by the household members throughout the current rounds interview.
Item |
Changes |
Year |
Text |
CL01 |
Simplified question text. |
2010 |
{[As I mentioned during the last interview], it/It} is important for us to get accurate names and addresses for medical providers so that we can contact them for more information about the services they provide. To do this, we must have written authorization from the family members receiving these services. I would like to get authorization from the following people:
[HAND RESPONDENT THE AUTHORIZATION FORM BOOKLET.]
[These materials explain more about why we contact medical providers and answer questions people sometimes ask about this part of the study. Please take a minute to review this information while I prepare the forms.] |
2013 |
{[As I mentioned during the last interview], we/We} request written authorization to contact medical providers for more information about the services they provide. I would like to get authorization from the following people:
[HAND RESPONDENT THE AUTHORIZATION FORM BOOKLET.]
[These materials explain more about why we contact medical providers and answer questions people sometimes ask about this part of the study. Please take a minute to review this information while I prepare the forms.] |
||
CL06A |
Introductory text added when CL01 has not been asked for RU. |
2010 |
PID: [PID-3] PERSON: [First,[Middle],Last Name-35] DOB: [MM/DD/YYYY] AGE: [XXX] STATUS: [Status Code Description] DATE ORIGINALLY INSTITUTIONALIZED: [MM/DD/YYYY] DATE REJOINED COMMUNITY/CHANGED STATUS: [MM/DD/YYYY]
SIGNATURE DATE ON MPC AF MUST BE ON OR AFTER: {MM/DD/YYYY}
INTERVIEWER: THE PERSON NAMED ABOVE WAS INSTITUTIONALIZED IN A PREVIOUS ROUND AND HAS NOW REJOINED THE COMMUNITY OR CHANGED STATUS. COMPLETE THE FOLLOWING STEPS:
1. FILL OUT HEALTH CARE INSTITUTION HISTORY.
2. COMPLETE A MPC AF FOR EACH DIFFERENT HEALTH CARE INSTITUTION LISTED ON HEALTH CARE INSTITUTION HISTORY. WRITE ‘IC’ IN UPPER LEFT CORNER OF MPC AF. REFER TO SECTION 3 OF HISTORY FOR INSTRUCTIONS ON COMPLETING THESE AF(S).
3. REQUEST SIGNATURE(S) ON AF(S).
4. LEAVE UNSIGNED AF(S) AND THE AF BOOKLET WITH RESPONDENT.
5. PLACE EACH SIGNED MPC AF IN THE CASE FOLDER. MAKE FOLLOW-UP ARRANGEMENTS FOR EACH UNSIGNED MPC AF. CAPI WILL NOT COLLECT INFORMATION ON STATUS.
PRESS ENTER OR SELECT NEXT PAGE TO CONTINUE. |
2013 |
PID: [PID-3] PERSON: [First,[Middle],Last Name-35] DOB: [MM/DD/YYYY] AGE: [XXX] STATUS: [Status Code Description] DATE ORIGINALLY INSTITUTIONALIZED: [MM/DD/YYYY] DATE REJOINED COMMUNITY/CHANGED STATUS: [MM/DD/YYYY] RU ID: [RUID-7] REGION: [Reg ID-1]
SIGNATURE DATE ON MPC AF MUST BE ON OR AFTER: {MM/DD/YYYY}
{We request written authorization to contact medical facilities for more information about the services they provide. [HAND RESPONDENT THE AUTHORIZATION FORM BOOKLET.] [These materials explain more about why we contact medical facilities and answer questions people sometimes ask about this part of the study. Please take a minute to review this information while I prepare the forms.]}
INTERVIEWER: THE PERSON NAMED ABOVE WAS INSTITUTIONALIZED IN A PREVIOUS ROUND AND HAS NOW REJOINED THE COMMUNITY OR CHANGED STATUS. COMPLETE THE FOLLOWING STEPS:
1. FILL OUT HEALTH CARE INSTITUTION HISTORY.
2. COMPLETE A MPC AF FOR EACH DIFFERENT HEALTH CARE INSTITUTION LISTED ON HEALTH CARE INSTITUTION HISTORY. WRITE ‘IC’ IN UPPER LEFT CORNER OF MPC AF. REFER TO SECTION 3 OF HISTORY FOR INSTRUCTIONS ON COMPLETING THESE AF(S).
3. REQUEST SIGNATURE(S) ON AF(S).
4. LEAVE UNSIGNED AF(S) AND THE AF BOOKLET WITH RESPONDENT.
5. PLACE EACH SIGNED MPC AF IN THE CASE FOLDER. MAKE FOLLOW-UP ARRANGEMENTS FOR EACH UNSIGNED MPC AF. CAPI WILL NOT COLLECT INFORMATION ON STATUS. |
||
CL29 |
Omitted; revised into CL30. |
2010 |
As you know, the Department of Health and Human Services is very interested in obtaining the most complete and accurate information about health care use and expenditures, including prescription medicines.
Many pharmacies now offer their customers a summary of their prescription medicine charges. People sometimes request these summaries to help in preparing their taxes or insurance claims.
To help us get the best information about the family’s prescriptions, we would like to obtain a printed summary from each pharmacy used by this family. To do this, we must have written authorization. |
2013 |
|
||
CL30 |
Revised text. |
2010 |
From the information I have, I would like to get a signed authorization form for:
(READ PERSON BELOW)’s prescriptions filled at (READ PHARMACY BELOW).
[HAND RESPONDENT THE AUTHORIZATION FORM BOOKLET.]
[These materials explain more about why we contact pharmacies and answer questions people sometimes ask about this part of the study. Please take a minute to review this information while I gather the forms.] |
2013 |
To obtain complete and accurate information about health care use and expenditures, we would like authorization to contact pharmacies to obtain a printed summary for:
(READ PERSON BELOW)’s prescriptions filled at (READ PHARMACY BELOW).
[HAND RESPONDENT THE AUTHORIZATION FORM BOOKLET.]
[These materials explain more about why we contact pharmacies and answer questions people sometimes ask about this part of the study. Please take a minute to review this information while I gather the forms.] |
||
CL41 |
Simplified question text. Round 5 revised to reference Quick Response Survey. |
2010 |
{In the coming months, we will be contacting this family again to collect information on health care use and expenses./We are nearing the end of this study. I’d like to thank you for your participation in this important study. Just in case my supervisor needs to reach you to verify that I was here and collected this information correctly, I’d like to verify a few pieces of information.}
{Just to make sure I can reach you for the next interview, I’d like to ask a few questions about how to find the family./Let me quickly review and update the information we have for locating the family that was collected during the last interview.} |
2013 |
{In the coming months, we will be contacting you again to collect information on health care use and expenses./We are nearing the end of this study. I’d like to verify a few pieces of information in case my supervisor needs to reach you to confirm that I was here and collected this information correctly. Also, AHRQ is sometimes asked to provide up-to-date information on health-related topics that are not covered in the MEPS survey. This year, they have asked us to contact a small number of MEPS households for a brief, 5-minute telephone interview. These calls will begin in the next month or so.}
{Just to make sure I can reach you for the next interview, I’d like to ask a few questions to help locate you in case you move./ Let me quickly review and update the information we have for locating you that was collected during the last interview.} |
||
CL51 |
Added probe for contact person relationship. |
2010 |
[What is the name, address, and phone number of that person?] |
2013 |
[What is the name, address, and phone number of that person?]
[PROBE: What is (his/her) relationship to {NAME OF REFERENCE PERSON}?] |
||
CL52 |
Omitted. Contact person relationship collected at CL51. |
2010 |
What is {NAME OF CONTACT PERSON FROM CL51}’s relationship to {NAME OF REFERENCE PERSON}? |
2013 |
|
||
CL52_2 |
Omitted. Relationship collected at CL51. |
2010 |
What is {NAME OF CONTACT PERSON FROM CL51}’s relationship to {NAME OF REFERENCE PERSON}? |
2013 |
|
||
CL65 |
Simplified question text. Added text reflecting the gift certificates distributed after Round 5. |
2010 |
Thank you again for your cooperation in this important research. {This check is a gift for your participation in this study. The next interview will take place in about six months./This check is a gift for your participation in this study.} |
2013 |
Thank you again for your cooperation in this important research. This check is a gift to show our appreciation. {The next interview will take place in about six months.}
{GIVE RESPONDENT CERTIFICATE: I would also like to thank you on behalf of the two Department of Health and Human Services agencies that sponsor this study -- the Agency for Healthcare Research and Quality and the Centers for Disease Control and Prevention. As a token of their appreciation, they would like you to have this certificate recognizing your time and effort participating in the Medical Expenditure Panel Survey.} |
Condition Enumeration (CE)
The Condition Enumeration section first obtains a summary assessment of each person's physical and mental health. It then identifies specific physical and mental health conditions, accidents, or injuries affecting each person. Using this information, this section creates a roster of conditions and health problems reported for each family member. Later in the interview, this roster links with health care utilization and disability day information.
Changes: None
Conditions (CN)
This section collects additional information about physical and mental health conditions identified through medical events or disability days. It obtains further details on each condition on each person's medical condition roster to determine if it was due to an accident or injury and whether it is on a priority list of conditions. If the condition is an accident or injury or a priority condition, subsequent questions ask whether a medical person has been consulted about the condition, when the condition was first noticed, the condition's severity, the current status of the condition, and any treatments received.
Changes: None
Dental Care (DN)
The Dental Care section obtains details on the nature of any dental care visit, type of dental care provider, treatments and services performed, and prescribed medicines.
Changes: None
Diabetes Care Self-Administered Questionnaire (Diabetes SAQ)
A brief self administered paper-and-pencil questionnaire on the quality of diabetes care is administered once a year (during round 3 and 5) to persons identified as having diabetes. Included are questions about the number of times the respondent reported having a hemoglobin A1c blood test, whether the respondent reported having his or her feet checked for sores or irritations, whether the respondent reported having an eye exam in which the pupils were dilated and the last time the respondent had his or her blood cholesterol checked and whether the diabetes has caused kidney or eye problems. Respondents are also asked if their diabetes is being treated with diet, oral medications or insulin.
Disability Days (DD)
The Disability Days section assesses the impact of any physical illness, injury, or mental or emotional problem on household members' attendance at work or school. These questions specify how many days of work or school were missed, for what health condition they were missed, and how many days were missed because of someone else's illness, injury, or health care needs.
Item |
Changes |
Year |
Text |
DD01 |
Added display specifications so that not all question text are displayed for every loop. |
2010 |
The next questions ask about time when (PERSON) may have missed a half day or more from work or school or spent a half day or more in bed {since (START DATE)/between (START DATE) and (END DATE)}. In answering these questions, please include any time when this occurred because of (PERSON)’s physical illness or injury, or a mental or emotional problem such as stress or depression. |
2013 |
{The next questions ask about time/Now think about} when {you/{(PERSON}} may have missed a half day or more from work or school or spent a half day or more in bed {since {START DATE}/between {START DATE} and {END DATE}}. {In answering these questions, please include any time when this occurred because of {your/{PERSON}’s} physical illness or injury, or a mental or emotional problem such as stress or depression.} |
Emergency Room (ER)
The Emergency Room section obtains information on the health conditions requiring emergency room care, medical services provided, any surgical procedures performed, prescribed medicines, and the physicians and surgeons providing emergency room care. This section collects physicians and surgeons who are not already on the provider roster.
Changes: None
Employment (EM)
The Employment section covers questions about each person's employment or self-employment status. For jobs identified, this section asks questions to obtain contact information for each employer. For several types of jobs, questions are asked about type of business or industry, firm size, how long the person has worked at each job, whether health insurance was offered, hours worked, and job titles or main duties. For persons who are currently employed, questions ask about periods of unpaid leave at their job. For those not currently working, questions ask about previous jobs and the reasons for not working. Questions are asked about whether the person's job was temporary or seasonal, as well as questions about health insurance, including whether it was offered to the person, whether it was offered to any employee, and why the person was not eligible. Informed consent is obtained regarding contacting employers who provide health insurance.
Item |
Changes |
Year |
Text |
EM01 |
Added display specifications so that not all question text are displayed for every loop. |
2010 |
Now I have some questions about work experience for (PERSON).
{During our last interview on {PREV RD INTV DATE}, we recorded that (PERSON) did not work at any job for pay.}
{(Do/Does)/As of 12/31/{YEAR}, did} (PERSON) {currently} have a job for pay or own a business {that we have not yet talked about}?
PROBE: Do not count work around the house. Include work in a family farm or business, even if unpaid. |
2013 |
{Now I have some questions about work experience for {you/{PERSON}}.} {During our last interview on {PREV RD INTV DATE}, we recorded that {you/{PERSON}} did not work at any job for pay.}
{{Do/Does}/As of 12/31/{YEAR}, did} {you/{PERSON}} {currently} have a job for pay or own a business {that we have not yet talked about}?
PROBE: Do not count work around the house. Include work in a family farm or business, even if unpaid. |
Employment Wage (EW)
The Employment Wage section collects detailed information about the wage structure for all non-self employed, current jobs identified in the previous Employment (EM) section.
Item |
Changes |
Year |
Text |
EW07 |
Question mark in first sentence changed to a period. |
2010 |
I would just like to get a rough idea of how much (PERSON) {(earn/earns)/earned} at this job? Approximately how much {(do/does)/did} (PERSON) make per hour? |
2013 |
I would just like to get a rough idea of how much {you/{PERSON}} {{earn/earns}/earned} at this job. Approximately how much {{do/does}/did} {you/he/she} make per hour? |
Event Driver (ED)
The Event Driver verifies and modifies information entered in the Provider Probes, Event Roster, and Provider Roster sections. It also provides an opportunity to add new medical events throughout the interview if the respondent recalls an event after completing the Provider Probes section.
Item |
Changes |
Year |
Text |
ED01 |
Omitted; combined with ED02. |
2010 |
{The next questions ask detail about each of the times (PERSON) received medical or dental care.} |
2013 |
|
||
ED02 |
Question text from ED01 added. |
2010 |
Let's talk about {the hospital stay for (PERSON) at (PROVIDER) that began on (ADMIT DATE)/when (PERSON) visited the emergency room at (PROVIDER) on (VISIT DATE)/when (PERSON) received medical care from an outpatient department at (PROVIDER) on (VISIT DATE)/when (PERSON) received medical care from (PROVIDER) on (VISIT DATE)/when (PERSON) received dental care from (PROVIDER) on (VISIT DATE)/the {OME ITEM GROUP NAME} used by (PERSON) since (START DATE)/the services (PERSON) received at home from (PROVIDER) during (MONTH)}. |
2013 |
{The next questions ask detail about each of the times {you/{PERSON}} received medical or dental care.}
Let's talk about {the hospital stay for {you/{PERSON}} at {PROVIDER} that began on {ADMIT DATE}/when {you/{PERSON}} visited the emergency room at {PROVIDER} on {VISIT DATE}/when {you/{PERSON}} received medical care from an outpatient department at {PROVIDER} on {VISIT DATE}/when {you/{PERSON}} received medical care from {PROVIDER} on {VISIT DATE}/when {you/{PERSON}} received dental care from {PROVIDER} on {VISIT DATE}/the {OME ITEM GROUP NAME} used by {you/{PERSON}} since {START DATE}/the services {you/{PERSON}} received at home from {PROVIDER} during {MONTH}}. |
Event Roster (EV)
Probes continue in this section for additional detail on event dates, type of event, and type of provider. This section creates a roster displaying this information as it is linked to each person. The Event Roster links to further sections that collect more detailed data on each specific type of event and then the charge and payment for each event.
Changes: None
Flat Fee (FF)
The Flat Fee section functions as a subsection of Charge Payment (CP). It captures information on those types of medical payment arrangements that charge a grouped amount, or flat fee, for multiple visits or services.
Changes: None¶
Health Insurance (HX)
The Health Insurance section collects information about private health insurance obtained through an employer, direct purchase private insurance plans, and public health insurance programs. It identifies the household members covered by health insurance, type of plan, name of each plan, nature of coverage under each plan, duration of coverage, and who pays various costs for the policy premiums. It also identifies the household members not covered by health insurance. For employer-sponsored coverage, this section creates a link to job characteristics collected in the Employment (EM) section of the questionnaire. For individuals who are uninsured at the beginning of the year, the section collects information on the length of time they have been uninsured. For private insurance policies, it obtains information on employer-related coverage and non-employer-related coverage (i.e., purchased through a group, association, school, small business group, insurance company, etc.). The Health Insurance section also collects information for public insurance on Medicare, Medicaid/SCHIP, Medicaid waiver programs, CHAMPUS/CHAMPVA (now TRICARE/CHAMPVA), and other government programs. Questions related to whether the insurance will cover part of the cost of an out-of-network provider are asked.
Item |
Changes |
Year |
Text |
HX01 |
Simplified question text. |
2010 |
Now I’d like to talk with you about health insurance, an important topic for most persons. We want to know about all the health coverage that anyone in the family may have had to help pay the costs of medical care at any time {since (START DATE)/between (START DATE) and (END DATE)}. |
2013 |
Let’s talk (again) about all the health insurance coverage the family may have to help pay for the costs of medical care {since {START DATE}/between {START DATE} and {END DATE}}. |
||
HX05 |
Simplified question text. |
2010 |
My records indicate that (READ NAMES BELOW) {(are/is)} {either} {65 years old or older} {or} {joined the household since our last interview}. |
2013 |
We show that (READ NAMES BELOW) {(are/is)} {either} {65 years old or older} {or} {joined the household since our last interview}. |
||
HX06 |
Simplified question text. |
2010 |
There are several large public health insurance programs {with similar names} that are easily confused.
Medicare is a health insurance program for persons 65 years or over and for disabled persons. Other programs, such as {Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME}, are state programs which cover low income families and individuals or children who do not have private health insurance.
Let me first ask about Medicare. People covered by Medicare usually have a card that looks like this.
At any time since (START DATE), has anyone in the family been covered by Medicare? |
2013 |
Medicare is a health insurance program for persons 65 years or over and for some disabled persons. People covered by Medicare usually have a card that looks like this.
At any time since {START DATE}, has anyone in the family been covered by Medicare? |
||
HX10 |
Simplified question text. |
2010 |
{Some people are covered by programs called {Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME}. These are state programs for low income families and individuals or children who do not have private health insurance. They sometimes cover persons with very large medical bills or those in nursing homes.}
{SHOW CARD HX-3.} {People covered by {Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME} usually have a (piece of paper/card) that looks something like this.}
{During the last interview, we recorded that no one in the family was covered by {Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME}.}
Has anyone in the family been covered by {Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME} at any time {since (START DATE)/between (START DATE) and (END DATE)}? |
2013 |
{Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME} are state programs that pay for health care for persons in need. People covered by {Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME} may have a (piece of paper/card) that looks something like this.
At any time {since {START DATE}/between {START DATE} and {END DATE}}, has anyone in the family been covered by {Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME}? |
||
HX12 |
Omitted first sentence. |
2010 |
{During the last interview, we recorded that no one in the family was covered by TRICARE or CHAMPVA.}
At any time {since (START DATE)/between (START DATE) and (END DATE)}, has anyone in the family been covered by TRICARE or CHAMPVA? |
2013 |
At any time {since {START DATE}/between {START DATE} and {END DATE}}, has anyone in the family been covered by TRICARE or CHAMPVA? |
||
HX14 |
Omitted first sentence; changed “obtained through” to “from.” |
2010 |
{During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.}
At any time {since (START DATE)/between (START DATE) and (END DATE)}, has anyone in the family had any other type of health insurance obtained through any state or local government agency which provided hospital and physician benefits? |
2013 |
At any time {since {START DATE}/between {START DATE} and {END DATE}}, has anyone in the family had any other type of health insurance from any state or local government agency which provided hospital and physician benefits? |
||
HX16 |
Omitted first sentence; slightly revised text. |
2010 |
{During the last interview, we recorded that no one in the family/Some people} receive{d} health benefits from other state programs such as (READ PROGRAM NAMES BELOW) or other public programs that provide coverage for health care services.
{STATE NAME FOR PROGRAM #1..................} {STATE NAME FOR PROGRAM #2..................} {STATE NAME FOR PROGRAM #3..................} {STATE NAME FOR PROGRAM #4..................}
At any time {since (START DATE)/between (START DATE) and (END DATE)}, has anyone in the family been covered by any program like this? |
2013 |
Some people receive health benefits from other state programs such as (READ PROGRAM NAMES BELOW) or other public programs that provide coverage for health care services.
{STATE NAME FOR PROGRAM #1..................} {STATE NAME FOR PROGRAM #2..................} {STATE NAME FOR PROGRAM #3..................} {STATE NAME FOR PROGRAM #4..................}
At any time {since {START DATE}/between {START DATE} and {END DATE}}, has anyone in the family been covered by any program like this? |
||
HX21 |
Added roster of insurance names. |
2010 |
Next, I have some questions about other sources of health insurance anyone in the family may have had {since (START DATE)/between (START DATE) and (END DATE)} to help pay hospital and doctor bills and other health expenses such as nursing home care or prescribed medicines. {This includes Medigap or Medicare Supplements, plans through a private insurance carrier, which some people who are eligible for Medicare have as additional coverage.} |
2013 |
Next, I have some questions about other sources of health insurance anyone in the family may have had {since {START DATE}/between {START DATE} and {END DATE}} to help pay hospital and doctor bills and other health expenses such as nursing home care or prescribed medicines. {This includes Medigap or Medicare Supplements, plans through a private insurance carrier, which some people who are eligible for Medicare have as additional coverage.}
{Since {START DATE}/Between {START DATE} and {END DATE}} we show the family has had the following health insurance: |
||
HX25 |
Revised to ask respondent to get out Medicare card rather than hand it to interviewer. |
2010 |
May I please see (PERSON)’s Medicare card?
IF NECESSARY, SAY: We do not need (PERSON)’s Medicare number, but would like to record the exact date (PERSON)’s Medicare coverage became effective and what type of coverage (PERSON) has through Medicare. |
2013 |
Can you please take out {your/{PERSON}’s} Medicare card?
We do not need {your/his/her} Medicare number, but would like to record the exact date {your/his/her} Medicare coverage became effective and what type of coverage {you/he/she} {have/has} through Medicare. |
||
HX26 |
Revised to ask respondent to get out Medicare card rather than hand it to interviewer. |
2010 |
INTERVIEWER: CODE MEDICARE CARD(S) SHOWN/AVAILABLE.
MEDICARE CARD (RED, WHITE AND BLUE) .... 1 RAILROAD RETIREMENT BOARD CARD (RED, WHITE AND BLUE) ........................ 2 SOME OTHER CARD ........................ 3 |
2013 |
Is that card a regular Medicare card, a Railroad Retirement Board card, or some other Medicare card? |
||
HX27 |
Revised to ask respondent to get out Medicare card rather than hand it to interviewer. |
2010 |
INTERVIEWER:
RECORD THE FOLLOWING INFORMATION FROM THE CARD:
EFFECTIVE DATE: [Enter Month,Day,Year-4]
TYPE OF COVERAGE (IS ENTITLED TO): HOSPITAL ONLY .......................... 1 MEDICAL AND HOSPITAL ................... 2 MEDICAL ONLY ........................... 3 |
2013 |
Please tell me the effective date listed on the card.
{Are/Is} {you/{PERSON}} entitled to hospital (Part A), medical (Part B), or both? |
||
HX31 |
Revised to ask respondent to read information from card rather than hand it to interviewer. |
2010 |
As you may know, Medicare allows beneficiaries to enroll in Medicare Advantage or managed care plans, such as HMOs (Health Maintenance Organizations) or PPOs (Preferred Provider Organizations) to receive their Medicare-funded health care. These plans have names like those listed on this card.
Is the name of (PERSON)’s insurance through Medicare{, as of (END DATE),} listed on this card? |
2013 |
Is the name of {your/{PERSON}’s} insurance plan through Medicare{, as of {END DATE},} listed on this card? |
||
HX32 |
Simplified question text. |
2010 |
Even though (PERSON)’s Medicare plan is not listed on the card, {(are/is) (PERSON) currently/(were/was) (PERSON)} enrolled in a Medicare managed care plan such as an HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization) {as of (END DATE)}? When answering this question, please include only insurance from Medicare, not any privately purchased insurance and not any job- related insurance. |
2013 |
{{Are/Is} {you/{PERSON}} currently/As of {END DATE}, {were/was} {you/{PERSON}} enrolled in a Medicare Advantage or managed care plan, such as an HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization) to receive {your/his/her} Medicare-funded health care? When answering, please include only insurance from Medicare, not any privately purchased or job-related insurance. |
||
HX34A |
First sentence revised to an “if necessary” statement. |
2010 |
Many Medicare beneficiaries pay the premium for their Medicare Advantage coverage through their Social Security checks. Some pay directly to the provider. How (do/does) (PERSON) pay for (PERSON)’s {{{PLAN NAME ENTERED AT HX31OV}/{NAME OF PLAN FROM HX33}}/Medicare managed care} premium? |
2013 |
How {do/does} {you/{PERSON}} pay for {your/his/her} {{{PLAN NAME ENTERED AT HX31OV}/{NAME OF PLAN FROM HX33}}/Medicare managed care} premium?
IF NECESSARY, SAY: Is the Medicare Advantage premium paid through {your/his/her} Social Security check, paid directly to the provider, or paid both ways? |
||
HX35C |
First sentence revised to an “if necessary” statement. |
2010 |
Many Medicare beneficiaries pay the premium for their Medicare drug coverage through their Social Security checks. Some pay directly to the provider? How (do/does) (PERSON) pay for (PERSON)’s Part D premium? |
2013 |
How {do/does} {your/{PERSON}} pay for {your/his/her} Part D premium?
IF NECESSARY, SAY: Is the Medicare drug coverage premium paid through {your/his/her} Social Security check, paid directly to the provider, or paid both ways? |
||
HX41 |
Omitted first paragraph. |
2010 |
{Some people on
{Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME} can
enroll in plans called HMOs. These plans have names like those
listed on this card.} |
2013 |
Is the name of the health insurance through {{Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME}/the program sponsored by a state or local government agency which provides hospital and physician benefits}{, between {START DATE} and {END DATE),}} listed on this card? |
||
HX42 |
Slightly revised question text. |
2010 |
Under {{Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME}/ the program sponsored by a state or local government agency which provides hospital and physician benefits} {(are/is)/(were/was)} (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization {between (START DATE) and (END DATE)}?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.] |
2013 |
Under {{Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME}/ the program sponsored by a state or local government agency which provides hospital and physician benefits} {(are/is)/(were/was)} (READ NAME(S) BELOW) enrolled in an HMO, that is a Health Maintenance Organization {between {START DATE} and {END DATE}}?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.] |
||
HX48 |
Simplified question text. |
2010 |
Now I’d like to ask a few questions about (POLICYHOLDER)’s health insurance through (ESTABLISHMENT). What type of health insurance {(do/does)/did} (POLICYHOLDER) get through (ESTABLISHMENT) {as of (END DATE)}?
PROBE: Any other health coverage through this plan? |
2013 |
Now think again about {your/{POLICYHOLDER}’s} health insurance through {ESTABLISHMENT}. Looking at this card, what health insurance coverage {{do/does}/did} {you/he/she} have {as of {END DATE}}?
PROBE: Any other health coverage through this plan? |
||
HX63A |
Bolded “or” for emphasis. |
2010 |
Is the {family} annual deductible for medical care for this plan less than {$1,200 or $1,200/$2,400 or $2,400} or more? If there is a separate deductible for prescription drugs, hospitalization, or out-of-network care, do not include those deductible amounts here. |
2013 |
Is the {family} annual deductible for medical care for this plan less than {$1,200 or $1,200/$2,400 or $2,400} or more? If there is a separate deductible for prescription drugs, hospitalization, or out-of-network care, do not include those deductible amounts here. |
||
HX63E |
Added phrase “per year” to question text. |
2010 |
How much {(do/does) (PERSON)/does your family} contribute to {this FSA/these FSAs all together}? |
2013 |
How much {{do/does} {you/{PERSON}}/does your family} contribute per year to {this FSA/these FSAs all together}? |
||
Help Text
HX05 HX06 |
Update Medicare definition to include Part C. |
2010 |
MEDICARE
-- A Federal health insurance program for people 65 or older and
for certain persons under 65 with long-term disabilities. Almost
everyone with Social Security is covered by Medicare. |
2013 |
MEDICARE
-- A Federal health insurance program for people 65 or older and
for certain persons under 65 with long-term disabilities. Almost
everyone with Social Security is covered by Medicare. |
Health Status (HE)
The Health Status section assesses the physical and mental health status for both children and adults. Specific areas assessed include limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), the use of health aids, physical limitations, activity limitations, mental impairments, vision impairments, and hearing difficulties. For children, this section obtains additional information on participation in special education or therapy services, general health status, height, weight and child care. Also included are questions assessing whether a person has had difficulty with or has required supervision for at least 3 months when performing daily activities.
Item |
Changes |
Year |
Text |
HE01 |
Simplified question text. |
2010 |
The next few questions are about difficulties people may have with everyday activities such as getting around, bathing or taking medications. We are interested in difficulties due to an impairment or a physical or mental health problem.
{Also, please keep in mind that we are only interested in difficulties family members may have had between (START DATE) and (END DATE).}
Does anyone in the family receive help or supervision using the telephone, paying bills, taking medications, preparing light meals, doing laundry, or going shopping? |
2013 |
{Between {START DATE} and {END DATE}, did/Does} anyone in the family receive help or supervision using the telephone, paying bills, taking medications, preparing light meals, doing laundry, or going shopping (because of an impairment or a physical or mental health problem)? |
||
HE04 |
Added reference dates and clarifications in parentheses. |
2010 |
Does anyone in the family receive help or supervision with personal care such as bathing, dressing, or getting around the house? |
2013 |
{Between {START DATE} and {END DATE}, did/Does} anyone in the family receive help or supervision with personal care such as bathing, dressing, or getting around the house (because of an impairment or a physical or mental health problem)? |
||
HE07 |
Added reference dates and clarifications in parentheses. |
2010 |
Does anyone in the family use any aids such as a walker, grab bars in the bathtub or any other special equipment for personal care or everyday activities? |
2013 |
{Between {START DATE} and {END DATE}, did/Does} anyone in the family use any aids such as a walker, grab bars in the bathtub or any other special equipment for personal care or everyday activities (because of an impairment or a physical or mental health problem)? |
||
HE09 |
Added reference dates and clarifications in parentheses. |
2010 |
Does anyone in the family have difficulties walking, climbing stairs, grasping objects, reaching overhead, lifting, bending or stooping, or standing for long periods of time? |
2013 |
{Between {START DATE} and {END DATE}, did/Does} anyone in the family have difficulties walking, climbing stairs, grasping objects, reaching overhead, lifting, bending or stooping, or standing for long periods of time (because of an impairment or a physical or mental health problem)? |
||
HE26 |
Item revised to comply with DHHS data collection standard on disability status. |
2010 |
Does anyone in the family wear eyeglasses or contact lenses? |
2013 |
With
this next set of questions we want to learn about people who Have
physical, mental, or emotional conditions that cause serious
difficulties with their daily activities. |
||
HE28 |
Item revised to comply with DHHS data collection standard on disability status. |
2010 |
Does anyone in the family have any difficulty seeing{[with glasses or contacts, if they use them]}? |
2013 |
Can {you/{PERSON}} not hear any speech at all, that is, {are/is} {you/{PERSON}} deaf? |
||
HE29 |
Item revised to comply with DHHS data collection standard on disability status. |
2010 |
Who is that? |
2013 |
Is anyone in the family blind or does anyone have serious difficulty seeing, even when wearing glasses? |
||
HE30 |
Item revised to comply with DHHS data collection standard on disability status. |
2010 |
Can {you/{PERSON}} not see anything at all, that is, {are/is} {you/he/she} blind? |
2013 |
Who is that? |
||
HE31 |
Item revised to comply with DHHS data collection standard on disability status. |
2010 |
{With glasses or contacts, can/Can} {you/{PERSON}} see well enough to read ordinary newspaper print, even if {you/he/she} cannot read? |
2013 |
Can {you/{PERSON}} not see anything at all, that is, {are/is} {you/{PERSON}} blind? |
||
HE32 |
Item revised to comply with DHHS data collection standard on disability status. |
2010 |
{With glasses or contacts, can/Can} {you/{PERSON}} see well enough to recognize familiar people if they are two or three feet away? |
2013 |
{Please
answer the next few questions for family members age 5 or
older.} |
||
HE33 |
Item revised to comply with DHHS data collection standard on disability status. |
2010 |
Does anyone in the family wear a hearing aid? |
2013 |
Who is that? |
||
HE34 |
Item revised to comply with DHHS data collection standard on disability status. |
2010 |
Who is that? |
2013 |
Does anyone in the family have serious difficulty walking or climbing stairs? |
||
HE35 |
Item revised to comply with DHHS data collection standard on disability status. |
2010 |
Does anyone in the family have any difficulty hearing{[with a hearing aid, if they use one]}? |
2013 |
Who is that? |
||
HE36 |
Item revised to comply with DHHS data collection standard on disability status. |
2010 |
Who is that? |
2013 |
Does anyone in the family have difficulty dressing or bathing? |
||
HE37 |
Item revised to comply with DHHS data collection standard on disability status. |
2010 |
Can {you/{PERSON}} not hear any speech at all, that is, {are/is} {you/he/she} deaf? |
2013 |
Who is that? |
||
HE38 |
Item revised to comply with DHHS data collection standard on disability status. |
2010 |
{With a hearing aid, can/Can} {you/{PERSON}} hear most of the things people say? |
2013 |
{Please
answer the next few questions for family members age 15 or
older.} |
||
HE39 |
Item revised to comply with DHHS data collection standard on disability status. |
2010 |
{With a hearing aid, can/Can} {you/{PERSON}} hear some of the things people say? |
2013 |
Who is that? |
||
HE40 |
Item added to comply with DHHS data collection standard on disability status. |
2010 |
|
2013 |
{Please
answer the next few questions for family members of all
ages.} |
Home Health (HH)
For those persons using home health care, the Home Health section obtains information on the types of health care workers providing home health services, reasons for home health care, the nature of home health services provided, frequency of visits, length per visits, and duration of visits.
Item |
Changes |
Year |
Text |
HH17 |
Added question mark to end of second sentence. |
2010 |
I have recorded that (PERSON) received services from (PROVIDER) during other months. Were the services received from (PROVIDER) during the other months similar to the services received during (VISIT MONTH). That is, in the other months, did (PROVIDER) visit {the same number of times/(READ FREQUENCY BELOW)} and provide {the same services/(READ SERVICES BELOW)}? |
2013 |
I have recorded that {you/{PERSON}} received services from {PROVIDER} during other months. Were the services received from {PROVIDER} during the other months similar to the services received during {VISIT MONTH}? That is, in the other months, did {PROVIDER} visit {the same number of times/(READ FREQUENCY BELOW)} and provide {the same services/(READ SERVICES BELOW)}? |
Hospital Stay (HS)
The Hospital Stay section obtains details on the length of stay, reasons or conditions requiring hospitalization, surgical procedures performed, medicines prescribed at discharge, and the physicians and surgeons providing hospital care. This section collects physicians and surgeons who are not already on the provider roster.
Item |
Changes |
Year |
Text |
HS03 |
Simplified question text. |
2010 |
Was this hospital stay related to any specific health condition or were any conditions discovered during this hospital stay? |
2013 |
Was this hospital stay related to any specific health condition or were any conditions discovered during this stay? |
||
HS06AA |
Addition; new question about time spent in an ICU. |
2010 |
|
2013 |
Did {you/{PERSON} spend any time in an intensive or critical care unit (ICU) during this stay? |
||
Help Text
HS06AA |
Add definition of ICU |
2010 |
|
2013 |
ICU
-- |
Income (IN)
This supplemental section, asked in Rounds 3 and 5, collects information about the household members' income and Federal income tax filing status, specifically about itemized deductions for health insurance premiums, tax credits, wages, other private income sources, and public assistance income.
Item |
Changes |
Year |
Text |
IN18A |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received [from wages or salary, tips, commissions, or bonuses in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received [from wages or salary, tips, commissions, or bonuses in {YEAR}]? |
||
IN19A |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received [in interest from savings accounts, bonds, NOW accounts, money market accounts, or similar types of investments in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received [in interest from savings accounts, bonds, NOW accounts, money market accounts, or similar types of investments in {YEAR}]? |
||
IN20A |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received [from dividends in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received [from dividends in {YEAR}]? |
||
IN21A |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received [from refunds of state or local taxes in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received [from refunds of state or local taxes in {YEAR}]? |
||
IN22A |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received [from alimony in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received [from alimony in {YEAR}]? |
||
IN23A |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was earned or lost [from (his/her/their) own farm or non-farm business or practice in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was earned or lost [from (his/her/their) own farm or non-farm business or practice in {YEAR}]? |
||
IN24A |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was earned or lost [from the sale of property or other assets, including the sale of (his/her/their) home, if it was taxable, in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was earned or lost [from the sale of property or other assets, including the sale of (his/her/their) home, if it was taxable, in {YEAR}]? |
||
IN25A |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received [from payments from IRA, Keogh, and 401K accounts in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received [from payments from IRA, Keogh, and 401K accounts in {YEAR}]? |
||
IN27 |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received [from private pensions, military retirement, other Federal government employee pensions, state or local government employee pensions, or annuities in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received [from private pensions, military retirement, Other Federal government employee pensions, state or local government employee pensions, or annuities in {YEAR}]? |
||
IN28A |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was earned or lost [from estates or trusts, partnerships, S corporations, royalties, or from rental income in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was earned or lost [from estates or trusts, partnerships, S corporations, royalties, or from rental income in {YEAR}]? |
||
IN30A |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received [from unemployment compensation in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received [from unemployment compensation in {YEAR}]? |
||
IN32 |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received [from Social Security and equivalent tier 1 Railroad Retirement benefits in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received [from Social Security and equivalent tier 1 Railroad Retirement benefits in {YEAR}]? |
||
IN36A |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received [from Worker’s Compensation in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received [from Worker’s Compensation in {YEAR}]? |
||
IN40C |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received per month [from Supplemental Security Income in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received per month [from Supplemental Security Income in {YEAR}]? |
||
IN45C |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received per month [from public assistance in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received per month [from public assistance in {YEAR}]? |
||
IN48C |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received per month [from child support in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received per month [from child support in {YEAR}]? |
||
IN51A |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received [from veteran’s payments such as education or disability benefits in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received [from veteran’s payments such as education or disability benefits in {YEAR}]? |
||
IN54C |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received per month [from regular cash contributions from people who do not live in this household, in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received per month [from regular cash contributions from people who do not live in this household, in {YEAR}]? |
||
IN62A |
Modified the question text that refers to the show card. |
2010 |
Looking at this card, which range best estimates how much money was received [from (INCOME SOURCE) in {YEAR}]? |
2013 |
Which of the ranges on this card is the best estimate of how much money was received [from (INCOME SOURCE) in {YEAR}]? |
||
Help Text IN55 |
Replace definition of Food Stamps with SNAP. |
2010 |
FOOD STAMPS - The Food Stamp Program enables low-income families to buy eligible, nutritious food with coupons and Electronic Benefits Transfer (EBT) cards in authorized retail food stores. |
2013 |
SUPPLEMENTAL
NUTRITION ASSISTANCE PROGRAM (SNAP) – |
Managed Care (MC)
This section determines whether household members are covered under a private managed care plan. The section groups the types of coverage as either HMO, other type of managed care plan, or non-managed care plan based on questions about the characteristics of the insurance plan.
Item |
Changes |
Year |
Text |
MC01 |
Simplified question text. |
2010 |
Now I will ask you a few questions about how (POLICYHOLDER)'s health insurance through (ESTABLISHMENT) {works/worked} for non-emergency care {as of (END DATE)}.
We are interested in knowing if (POLICYHOLDER)'s (ESTABLISHMENT) plan is an HMO, that is, a Health Maintenance Organization. With an HMO, you must generally receive care from HMO physicians. For other doctors, the expense is not covered unless you were referred by the HMO or there was a medical emergency.
{When answering this question, do not consider (POLICYHOLDER)’s insurance through Medicare.}
{Is/Was} (POLICYHOLDER)’s {NAME OF INSURER BEING LOOPED ON} an HMO {as of (END DATE)}? |
2013 |
{Is/Was} {your/{POLICYHOLDER}’s} {NAME OF INSURER BEING LOOPED ON} an HMO {as of {END DATE}}? {When answering this question, do not consider {your/his/her} insurance through Medicare.}
[With an HMO, you must generally receive care from HMO physicians. For other doctors, the expense is not covered unless you were referred by the HMO or there was a medical emergency.] |
Medical Provider Visits (MV)
The Medical Provider Visits section obtains details on the nature of any contacts or visits, the type of provider, health conditions requiring medical provider services, treatments and services performed, surgical procedures, and prescribed medicines. This section also probes for any follow up or repeat visits that cost the same amount as the original visit. Questions are asked about the medical provider's specialty and the medical provider's place type (e.g., managed care plan center or doctor's office).
Changes: None
Old Employment/ Private Related Insurance (OE)
For RU members that still hold the same job in Rounds 2 through 5 that was reported during the previous round as providing health insurance, this section collects information about the continuation of insurance coverage. Included are questions about whether the policyholder was responsible for any amount of the charge, whether there was an additional name for the insurance, and payments to out-of-network providers were added.
Item |
Changes |
Year |
Text |
0E01 |
Simplified question text. |
2010 |
During the last interview, we recorded that someone in the family was covered by (POLICYHOLDER)’s (ESTABLISHMENT) health insurance. {(Are/Is)/(Were/Was)} (POLICYHOLDER) or anyone in the family covered by (POLICYHOLDER)’s health insurance through (ESTABLISHMENT) as of {today,} (END DATE)? |
2013 |
Now think about {your/{POLICYHOLDER}’s} health insurance through {ESTABLISHMENT}. {{Are/Is}/{Were/Was}} {you/he/she} or anyone in the family covered by this insurance as of {today,} {END DATE}? |
||
OE03 |
Simplified question text. |
2010 |
During the last interview, we recorded that (READ NAMES BELOW) (were/was) covered by (POLICYHOLDER)’s health insurance through (ESTABLISHMENT). |
2013 |
{Are/Were} (READ NAMES BELOW) all covered by {your/{POLICYHOLDER}’s} health insurance through {ESTABLISHMENT} {until {{OE02 DATE}/it ended}/on {END DATE}}? |
||
OE09B |
Bolded the “or” for emphasis. |
2010 |
Is the {family} annual deductible for medical care for this plan less than {$1,200 or $1,200/$2,400 or $2,400} or more? If there is a separate deductible for prescription drugs, hospitalization, or out-of-network care, do not include those deductible amounts here. |
2013 |
Is the {family} annual deductible for medical care for this plan less than {$1,200 or $1,200/$2,400 or $2,400} or more? If there is a separate deductible for prescription drugs, hospitalization, or out-of-network care, do not include those deductible amounts here. |
||
OE10 |
Revised text to reference show card. |
2010 |
What type of health insurance {(do/does)/did} (POLICYHOLDER) {now} have through (ESTABLISHMENT)’s new plan {as of (END DATE)}? |
2013 |
Looking at this card, what type of health insurance coverage {{do/does}/did} {you/{POLICYHOLDER}} {now} have through {ESTABLISHMENT}’s new plan {as of {END DATE}}? |
||
0E12 |
Simplified question text. |
2010 |
During the last interview, we recorded that someone in the family was covered by (POLICYHOLDER)’s (ESTABLISHMENT) health insurance. {(Are/Is)/(Were/Was)} (POLICYHOLDER) or anyone in the family covered by (POLICYHOLDER)’s health insurance through (ESTABLISHMENT) as of {today,} (END DATE)? |
2013 |
Now think about {your/{POLICYHOLDER}’s} health insurance through {ESTABLISHMENT}. {{Are/Is}/{Were/Was}} {you/he/she} or anyone in the family covered by this insurance as of {today,} {END DATE}? |
||
OE17 |
Simplified question text. |
2010 |
During the last interview, we recorded that (READ NAMES BELOW) (were/was) covered by (POLICYHOLDER)’s health insurance through (ESTABLISHMENT).
{Are/Were} they all covered by this health insurance {until {{OE15 DATE}/it ended}/on (END DATE)}? |
2013 |
{Are/Were} (READ NAMES BELOW) all covered by {your/{POLICYHOLDER}’s} health insurance through {ESTABLISHMENT} {until {{OE15 DATE}/it ended}/on {END DATE}}? |
||
OE23B |
Bolded the “or” for emphasis. |
2010 |
Is the {family} annual deductible for medical care for this plan less than {$1,200 or $1,200/$2,400 or $2,400} or more? If there is a separate deductible for prescription drugs, hospitalization, or out-of-network care, do not include those deductible amounts here. |
2013 |
Is the {family} annual deductible for medical care for this plan less than {$1,200 or $1,200/$2,400 or $2,400} or more? If there is a separate deductible for prescription drugs, hospitalization, or out-of-network care, do not include those deductible amounts here. |
||
OE24 |
Revised text to reference show card. |
2010 |
What type of health insurance {(do/does)/did} (POLICYHOLDER) {now} have through (ESTABLISHMENT)’s new plan {as of (END DATE)}? |
2013 |
Looking at this card, what type of health insurance coverage {{do/does}/did} {you/{POLICYHOLDER}} {now} have through {ESTABLISHMENT}’s new plan {as of {END DATE}}? |
||
OE26 |
Simplified question text. |
2010 |
During the last interview, we recorded that someone in the family was covered by (POLICYHOLDER)’s (ESTABLISHMENT) health insurance. {(Are/Is)/(Were/Was)} (POLICYHOLDER) or anyone in the family covered by (POLICYHOLDER)’s health insurance through (ESTABLISHMENT) as of {today,} (END DATE)? |
2013 |
Now think about {your/{POLICYHOLDER}’s} health insurance through {ESTABLISHMENT}. {{Are/Is}/{Were/Was}} {you/he/she} or anyone in the family covered by this insurance as of {today,} {END DATE}? |
||
OE29 |
Simplified question text. |
2010 |
During the last interview, we recorded that (READ NAMES BELOW) (were/was) covered by (POLICYHOLDER)’s health insurance through (ESTABLISHMENT).
{Are/Were} they all covered by this health insurance {until {{OE28 DATE}/it ended}/on (END DATE)}? |
2013 |
{Are/Were} (READ NAMES BELOW) all covered by {your/{POLICYHOLDER}’s} health insurance through {ESTABLISHMENT} {until {{OE28 DATE}/it ended}/on {END DATE}}? |
||
0E35B |
Bolded the “or” for emphasis. |
2010 |
Is the {family} annual deductible for medical care for this plan less than {$1,200 or $1,200/$2,400 or $2,400} or more? If there is a separate deductible for prescription drugs, hospitalization, or out-of-network care, do not include those deductible amounts here. |
2013 |
Is the {family} annual deductible for medical care for this plan less than {$1,200 or $1,200/$2,400 or $2,400} or more? If there is a separate deductible for prescription drugs, hospitalization, or out-of-network care, do not include those deductible amounts here. |
||
OE37 |
Revised text to reference show card. |
2010 |
What type of health insurance {(do/does)/did} (POLICYHOLDER) {now} have through (ESTABLISHMENT)’s new plan {as of (END DATE)}? |
2013 |
Looking at this card, what type of health insurance coverage {{do/does}/did} {you/{POLICYHOLDER}} {now} have through {ESTABLISHMENT}’s new plan {as of {END DATE}}? |
||
OE39 |
Simplified question text. |
2010 |
During the last interview, we recorded that someone in the family was covered by (POLICYHOLDER)’s (ESTABLISHMENT) health insurance. {Is/Was} anyone in the family, living here {now}, covered by (POLICYHOLDER)’s health insurance through (ESTABLISHMENT) as of {today,} (END DATE)? |
2013 |
Now think about {your/{POLICYHOLDER}’s} health insurance through {ESTABLISHMENT}. {Is/Was} anyone in the family, living here {now}, covered by this insurance as of {today,} {END DATE}? |
||
OE41 |
Simplified question text. |
2010 |
During the last interview, we recorded that (READ NAMES BELOW) (were/was) covered by (POLICYHOLDER)’s health insurance through (ESTABLISHMENT).
{Are/Were} they all covered by this health insurance {until {{OE40 DATE}/it ended}/on (END DATE)}? |
2013 |
{Are/Were} (READ NAMES BELOW) all covered by {your/{POLICYHOLDER}’s} health insurance through {ESTABLISHMENT} {until {{OE40 DATE}/it ended}/on {END DATE}}? |
Old Public Related Insurance (PR)
For RU members who were covered during the previous round by Medicare, Medicaid/SCHIP, CHAMPUS/CHAMPVA (now TRICARE/CHAMPVA), or other state or local government sponsored programs, this section collects information about the continuation of coverage provided through these public programs.
Item |
Changes |
Year |
Text |
PR02 |
Omitted second paragraph. |
2010 |
During the last interview, it was recorded that (PERSON) (were/was) enrolled in Medicare. We would like to update information about (PERSON)’s Medicare coverage.
As you may know, Medicare allows beneficiaries to enroll in Medicare Advantage or managed care plans such as HMOs (Health Maintenance Organizations) or PPOs (Preferred Provider Organizations) to receive their Medicare funded health care. These plans have names like those listed on this card.
Is the name of (PERSON)’s insurance through Medicare{, as of (END DATE),} listed on this card? |
2013 |
During the last interview, it was recorded that {you/{PERSON}} {were/was} enrolled in Medicare. We would like to update information about {your/his/her} Medicare coverage.
Is the name of {your/{PERSON}’s} insurance plan through Medicare{, as of {END DATE},} listed on this card? |
||
PR03 |
Simplified question text. |
2010 |
Even though (PERSON)’s Medicare plan is not listed on the card, {(are/is) (PERSON) currently/(were/was) (PERSON)} enrolled in a Medicare managed care plan such as an HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization){as of (END DATE)}? When answering this question, please include only insurance from Medicare, not any privately purchased insurance and not any job-related insurance. |
2013 |
{{Are/Is} {you/{PERSON}} currently/As of {END DATE}, {were/was} {you/{PERSON}}} enrolled in a Medicare Advantage or managed care plan, such as an HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization) to receive {your/his/her} Medicare-funded health care? When answering, please include only insurance from Medicare, not any privately purchased or job-related insurance. |
||
PR06A |
First sentence revised into a “if necessary” statement. |
2010 |
Many Medicare beneficiaries pay the premium for their Medicare Advantage coverage through their Social Security checks. Some pay directly to the provider. How (do/does) (PERSON) pay for (PERSON)’s {{{PLAN NAME ENTERED AT PR02OV}/{NAME OF PLAN FROM PR04}}/Medicare managed care} premium? |
2013 |
How {do/does} {you/{PERSON}} pay for {your/his/her} {{PLAN NAME ENTERED AT PR02OV}/{NAME OF PLAN FROM PR04}}/Medicare managed care} premium?
IF NECESSARY, SAY: Is the Medicare Advantage premium paid through {you/his/her} Social Security check, paid directly to the provider, or paid both ways? |
||
PR06B |
Omitted first paragraph. |
2010 |
{During the last interview, it was recorded that (PERSON) (were/was) enrolled in Medicare. We would like to update information about (PERSON)’s Medicare coverage.}
{(Are/Is)/(Were/Was)} (PERSON) enrolled in Medicare Part D, also known as the Medicare Prescription Drug Plan {as of (END DATE)}? |
2013 |
{{Are/Is}/{Were/Was}} {you/{PERSON}} enrolled in Medicare Part D, also known as the Medicare Prescription Drug Plan {as of {END DATE}}? |
||
PR06D |
First sentence revised into a “if necessary” statement. |
2010 |
Many Medicare beneficiaries pay the premium for their Medicare drug coverage through their Social Security checks. Some pay directly to the provider? How (do/does) (PERSON) pay for (PERSON)’s Part D premium? |
2013 |
How {do/does} {you/{PERSON}} pay for {your/his/her} Part D premium?
IF NECESSARY, SAY: Is the Medicare drug coverage premium paid through {your/his/her} Social Security check, paid directly to the provider, or paid both ways? |
||
PR12 |
Omitted first paragraph. |
2010 |
Some people on {Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME} can enroll in plans called HMOs. These plans have names like those listed on this card.
Is the name of the health insurance through {Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME} {, between (START DATE) and (END DATE),} listed on this card? |
2013 |
Is the name of the health insurance through {Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME} {, between {START DATE} and {END DATE},} listed on this card? |
||
PR13 |
Revised “signed up” to “enrolled.” |
2010 |
Under {Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME} {(are/is)/(were/was)} (READ NAME(S) BELOW) signed up with an HMO, that is a Health Maintenance Organization {between (START DATE) and (END DATE)}?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.] |
2013 |
Under {Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME} {(are/is)/(were/was)} (READ NAME(S) BELOW) enrolled in an HMO, that is a Health Maintenance Organization {between {START DATE} and {END DATE}}?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.] |
||
PR16 |
Revised text to be consistent with the question text wording of HX45. |
2010 |
For the coverage through {{{PLAN NAME ENTERED AT PR12OV}/{NAME OF PLAN FROM PR15}}/{Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME}}, does anyone in the family pay anything for this coverage?
[Do not include the cost of any copayments, coinsurance, or deductibles anyone in the family may have had to pay.] |
2013 |
Does anyone in the family pay anything for the coverage through {{{PLAN NAME ENTERED AT PR12OV}/{NAME OF PLAN FROM PR15}}/{Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME}}?
[Do not include the cost of any copayments, coinsurance, or deductibles anyone in the family may have had to pay.] |
||
PR29 |
Revised “signed up” to “enrolled.” |
2010 |
Under the program sponsored by a state or local government agency which provides hospital and physician benefits {(are/is)/ (were/was)} (READ NAME(S) BELOW) signed up with an HMO, that is a Health Maintenance Organization {between (START DATE) and (END DATE)}?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.] |
2013 |
Under the program sponsored by a state or local government agency which provides hospital and physician benefits {(are/is)/(were/was)} (READ NAME(S) BELOW) enrolled in an HMO, that is a Health Maintenance Organization {between {START DATE} and {END DATE}}?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.] |
||
PR32 |
Revised text to be consistent with the question text wording of HX45 and PR16. |
2010 |
For the coverage through {{{PLAN NAME ENTERED AT PR28OV}/{NAME OF PLAN FROM PR31}}/the program sponsored by a state or local government agency which provides hospital and physician benefits}, does anyone in the family pay anything for this coverage?
[Do not include the cost of any copayments, coinsurance, or deductibles anyone in the family may have had to pay.] |
2013 |
Does anyone in the family pay anything for the coverage through {{{PLAN NAME ENTERED AT PR28OV}/{NAME OF PLAN FROM PR31}}/the program sponsored by a state or local government agency which provides hospital and physician benefits}?
[Do not include the cost of any copayments, coinsurance, or deductibles anyone in the family may have had to pay.] |
Other Medical Expenses (OM)
This section serves to direct the CAPI program to other sections in cases where respondents report expenses for glasses or contact lenses or for insulin and other diabetic equipment or supplies.
Changes: None
Outpatient Department (OP)
If any outpatient visits were made during the reference period, this section obtains details on the nature of the contact, type of care received, health conditions requiring outpatient services, treatments and services performed, surgical procedures, prescribed medicines, and the physicians and surgeons providing outpatient services. This section collects physicians and surgeons who are not already on the provider roster. It also probes for any follow up or repeat visits that cost the same amount as the original outpatient visit.
Changes: None
Overall Structure of Employment (EM-O)
Because most private health insurance is provided through employment, the MEPS interview collects detailed information on jobs held by each person in the household aged 16 or older. This section functions to direct the CAPI program through the loop of employment-related questions for each person 16 or older.
Changes: None
Prescribed Medicines (PM)
The Prescribed Medicines section obtains details on prescribed medicines reported in earlier medical events sections as well as additional prescriptions reported in this section. Questions determine whether free pharmaceutical samples were obtained, the specific health problems for which the medicine was prescribed, the number of refills obtained during the reference period, the first date of use of each medicine, and the name and address of the pharmacy that filled each prescription.
Item |
Changes |
Year |
Text |
PM01 |
Omitted. |
2010 |
The next questions are about prescription medicines (PERSON) purchased or received {since (START DATE)/between (START DATE) and (END DATE)}.
[It would be very helpful for the following questions if we could look at the bottles, containers, tubes, or bags for each of the medicines we will be talking about.] |
2013 |
|
||
PM04 |
Second paragraph from PM01 added. |
2010 |
{Since (START DATE)/Between (START DATE) and (END DATE)}, (have/has) (PERSON) obtained any medicines [we have not yet talked about]? For example, (have/has) (PERSON) had any new prescriptions or a refill of a prescription?
Please include any on-line prescriptions. |
2013 |
{Since {START DATE}/Between {START DATE} and {END DATE}}, {have/has} {you/{PERSON}} obtained any medicines [we have not yet talked about]? For example, {have/has} {you/he/she} had any new prescriptions or a refill of a prescription?
Please include any on-line prescriptions.
[It would be very helpful if we could look at the bottles, containers, tubes, or bags for each of the medicines we will be talking about.] |
Preventive Care (AP)
The Preventive Care supplemental section, asked in Round 3 and 5, gathers information on any preventive care received. Questions ask about frequency of dental and physical check-ups, flu shots, and other preventative health exams.
Item |
Changes |
Year |
Text |
AP17 |
Moved first paragraph to an “If necessary” phrase after the question. |
2010 |
A routine check-up is a visit with a doctor or other health professional for assessing overall health, usually not prompted by a specific illness or complaint. It usually includes a blood pressure check, and may include taking a blood sample for analysis and questions about health behaviors such as smoking.
About how long has it been since (PERSON) had a routine check-up by a doctor or other health professional? |
2013 |
About how long has it been since (PERSON) had a routine check-up by a doctor or other health professional?
IF NECESSARY, SAY: A routine check-up is a visit with a doctor or other health professional for assessing overall health, usually not prompted by a specific illness or complaint. It usually includes a blood pressure check, and may include taking a blood sample for analysis and questions about health behaviors such as smoking. |
||
AP17A |
Deleted introductory text. |
2010 |
Doctors or other health professionals often advise people to make a change to their lifestyles to lower their risk of developing a number of diseases, including heart disease.
Has a doctor or other health professional ever advised (PERSON) to... |
2013 |
Has a doctor or other health professional ever advised (PERSON) to... |
||
AP28 |
Changed three times a week to five times a week. |
2010 |
(Do/Does) (PERSON) now spend half an hour or more in moderate or vigorous physical activity at least three times a week? |
2013 |
(Do/Does) (PERSON) now spend half an hour or more in moderate or vigorous physical activity at least five times a week? |
||
AP32 |
Simplified question text. |
2010 |
When (PERSON) drive(s) or ride(s) in a car, would (PERSON) say (PERSON) wear(s) a seat belt...
Always, Nearly Always, Sometimes, Seldom, or Never? |
2013 |
Would {you say you wear/(PERSON) say (he/she) wears} a seat belt when driving or riding in a car...
Always, Nearly Always, Sometimes, Seldom, or Never? |
Priority Conditions (Quality Supplement) (PC)
The Priority Conditions section collects information about diabetes and asthma. This is a supplemental section asked in Rounds 3 and 5.
Item |
Changes |
Year |
Text |
PC02A |
Simplified question text. |
2010 |
The care of adults with diabetes is an interest of the Public Health Service. {During an earlier interview, it/It} was mentioned that (PERSON) (have/has) diabetes. We have a short questionnaire on the care adults may get for their diabetes. |
2013 |
{During an earlier interview, it/It} was mentioned that (PERSON) (have/has) diabetes. To obtain more information on the care of adults with diabetes, we have a short questionnaire for (PERSON). |
Priority Conditions Enumeration (PE)
The Priority Conditions Enumeration section includes questions which obtain a summary assessment of each person's physical and mental health. Additionally, information is collected about a select group of medical conditions including attention deficit hyperactivity disorder, attention deficit disorder, diabetes, asthma, high cholesterol, hypertension, coronary heart disease, angina, heart attacks, other heart disorders, strokes, emphysema, chronic bronchitis, cancer, joint pain, and arthritis. Using this information, this section creates a roster of conditions and health problems reported for each family member. Later in the interview, this roster links with health care utilization and disability day information.
Item |
Changes |
Year |
Text |
Help Text
PE11 |
Insert definition of other types of heart conditions. |
2010 |
|
2013 |
OTHER
TYPES OF HEART CONDITIONS TO INCLUDE -- |
||
Help Text
PE13 |
Insert definition of TIA. |
2010 |
|
2013 |
TRANSIENT
ISCHEMIC ATTACK – |
||
Help Text
PE15 |
Insert definition of emphysema. |
2010 |
|
2013 |
EMPHYSEMA
– |
Private Health Insurance Detail (HP)
This section collects additional detail on each private health insurance policy, including the name of the insurance company, the policyholder of each plan identified, and the household members covered by each policy. Informed consent information regarding contacting employers who provide health insurance is obtained.
Changes: None
Provider Directory (PD)
The Provider Directory section compiles a directory of all medical persons and medical facilities reported by MEPS respondents. It clarifies the relationship of each medical provider to the person's insurance plan and verifies the name, address, and telephone number of the provider.
Item |
Changes |
Year |
Text |
PD03 |
Simplified question text |
2010 |
Now I would like to make sure I have complete information for the medical providers you mentioned. I will use a directory to look up the names, addresses, and telephone numbers of the sources of medical care you mentioned. |
2013 |
To make sure my information is complete, I am going to use a directory to look up the medical providers you mentioned. |
Provider Probes (PP)
The Provider Probes section collects the information required to create a medical event in the database, i.e., the type of event, the person incurring the event, the health care provider, and the date(s) of the event. This section links with the Event Roster, Provider Roster, and Event Driver sections. Included are questions about independent labs/testing facilities and alternative care.
Item |
Changes |
Year |
Text |
PP03A |
Simplified question text. |
2010 |
As you know, it is important for us to get complete and accurate information of all of the family’s health care events. I’d like you to take a few minutes to look at several lists of health care providers, to be sure we haven’t missed any visits or calls, including those made just for advice, prescriptions, tests, shots, or x-rays. Please be sure to include any visits or phone calls to a health care provider that you haven’t told me about that were related to any health conditions we may have already discussed. |
2013 |
Next, I am going to show you several lists of health care providers to be sure we haven’t missed any visits or phone calls, including those made just for advice, prescriptions, tests, shots, or x-rays. |
||
PP12 |
Added the phrase “or supplies.” |
2010 |
{And finally, did/Did/Between (START DATE) and (END DATE), did} anyone in the family obtain eyeglasses, contact lenses, or diabetic equipment {since (START DATE)} [other than what we have already talked about]? |
2013 |
{And finally, did/Did/Between {START DATE} and {END DATE}, did} anyone in the family obtain eyeglasses, contact lenses, or diabetic equipment or supplies {since {START DATE}} [other than what we have already talked about]? |
||
PP13 |
Added the phrase “or supplies.” |
2010 |
Has anyone else in the family obtained eyeglasses, contact lenses, or diabetic equipment [other than what we have already talked about]? |
2013 |
Has anyone else in the family obtained eyeglasses, contact lenses, or diabetic equipment or supplies [other than what we have already talked about]? |
||
PP13A |
Simplified question text. |
2010 |
Now I would like you to think about the entire calendar year {YEAR}, that is from January 1, {YEAR} until December 31, {YEAR}.
Please look at the types of other medical expenses listed on this card. Did anyone in the family obtain any of these types of other medical expenses during the year {YEAR}? |
2013 |
Now I would like you to think about the entire calendar year {YEAR}, that is from January 1, {YEAR} until December 31, {YEAR}.
During {YEAR}, did anyone in the family have expenses for any of the types of things listed on this card? |
||
PP14 |
Simplified question text. |
2010 |
These next questions ask about the different medical and dental care anyone in the family has received {since (START DATE)/between (START DATE) and (END DATE)}. It is sometimes hard to remember dates accurately so take your time. You might want to look at any calendar you may keep, checkbook, or receipts to help you remember. We are interested in any type of visit or call, including those made just for advice, prescriptions, tests, shots, or x-rays. Also include any visits or phone calls to a health care provider that were related to any conditions we may have already discussed. |
2013 |
These next questions ask about medical and dental care each family member received {since {START DATE}/between {START DATE} and {END DATE}}. You can use your calendar, electronic records, checkbook, or receipts to help you remember. We are interested in any type of visit or phone call, including those made just for advice, prescriptions, tests, shots, or x-rays. |
||
PP27 |
Added the phrase “or supplies.” |
2010 |
{Since (START DATE)/Between (START DATE) and (END DATE)}, did (PERSON) obtain eyeglasses, contact lenses, or diabetic equipment? |
2013 |
{Since {START DATE}/Between {START DATE} and {END DATE}}, did {you/{PERSON}} obtain eyeglasses, contact lenses, or diabetic equipment or supplies? |
||
PP29 |
Simplified question text. |
2010 |
Now I would like you to think about the entire calendar year {YEAR}, that is from January 1, {YEAR} until December 31, {YEAR}.
Please look at the types of other medical expenses listed on this card. Did (PERSON) obtain any of these types of other medical expenses during the year {YEAR}? |
2013 |
Now I would like you to think about the entire calendar year {YEAR}, that is from January 1, {YEAR} until December 31, {YEAR}.
During {YEAR}, did {you/{PERSON}} have expenses for any of the types of things listed on this card? |
Provider
Roster (PV)
This section creates a roster to display the name and street address of each provider and/or facility associated with each person's medical events detailed in the Event Roster. This information is strictly confidential.
Changes: None
RU Information Screen (RS)
To assist in conducting subsequent interviews, the interviewer records helpful information in this section, such as special instructions, special problems, locating directions, difficulties with the CAPI administration, and whether the household moved.
Changes: None
Reenumeration-A (RE-A)
Reenumeration refers to the process of collecting eligibility and demographic data on each person associated with a household participating in MEPS. The Reenumeration section has two parts, Reenumeration-A and Reenumeration-B. RE-A -- Reenumeration-A Part A includes questions RE01 through RE75, which identify and define the eligibility status for each person and family unit living within each MEPS sampled household, as well as any family members who are temporarily living away from the household. Part A identifies the reference period for each family unit and the person that serves as the primary respondent for the family is identified. It also obtains age, gender, and marital status for each person.
Reenumeration-B (RE-B)
Reenumeration-B Part B of the Reenumeration section includes questions RE76 through RE112. This section details how family members are related to one another and the size of the family unit. Race, ethnicity, educational attainment, and military status for each person are specified.
Item |
Changes |
Year |
Text |
RE98A |
Item revised to comply with DHHS data collection standard. |
2010 |
(Do/Does) (PERSON) consider (yourself/himself/herself) Hispanic or Latino? |
2013 |
{Are/Is} {you/{PERSON}} Hispanic, Latino, or Spanish origin? |
||
RE100A |
Item revised to comply with DHHS data collection standard. |
2010 |
Please look at this card and tell me which group best describes (PERSON)’s ethnic background. |
2013 |
Please look at this card and tell me which group or groups best describes {your/{PERSON}’s} ethnic background. |
||
RE101A |
Item revised to comply with DHHS data collection standard. |
2010 |
Please look at this card and tell me which race or races best describes (PERSON). |
2013 |
For this survey, Hispanic origins are not races.
What is {your/{PERSON}’s} race? Please select one or more of the categories on this card. |
||
RE101B |
Item omitted to comply with DHHS data collection standard. |
2010 |
Please look at this card and tell me which group best describes (PERSON)’s ethnic background. |
2013 |
|
||
RE102 |
Item added to comply with DHHS data collection standard. |
2010 |
|
2013 |
Does anyone in your family speak a language other than English at home? |
||
RE102A |
Item added to comply with DHHS data collection standard. |
2010 |
|
2013 |
What is this language? |
||
RE102B |
Item added to comply with DHHS data collection standard. |
2010 |
|
2013 |
How well {do/does} {you/{PERSON}} speak English?
Would you say
Very well, well, not well, or not at all? |
||
RE102C |
Item added to comply with DHHS data collection standard. |
2010 |
|
2013 |
{Were/Was} {you/{PERSON}} born in the United States? |
||
RE102D |
Item added to comply with DHHS data collection standard. |
2010 |
|
2013 |
In what year did {you/{PERSON}} come to the United States to stay? |
||
RE102E |
Item added to comply with DHHS data collection standard |
2010 |
|
2013 |
About how long {have/has} {you/{PERSON}} lived in United States? |
||
RE103 |
Edited to mirror NHIS education item. |
2010 |
{As of December 31, {YEAR}, what/What} is the highest grade or year of regular school (PERSON) ever completed? |
2013 |
{As of December 31, {YEAR}, what/What} is the highest level of school {you/{PERSON}} {have/has} completed or the highest {you/he/she} received?
Please tell me the category from the card that best describes{your/his/her} highest level of school completed. |
||
RE104 |
Omitted. Highest degree collected at RE103. |
2010 |
{{Do/Does/Did}/As of December 31, {YEAR} did} (PERSON) have a high school diploma or {{have/has/had}/had} (PERSON) passed the GED equivalency test? |
2013 |
|
||
RE105 |
Omitted. Highest degree collected at RE103. |
2010 |
What is the highest educational degree (PERSON) obtained {as of December 31, {YEAR}}? |
2013 |
|
||
RE106 |
Omitted; combined with RE108. |
2010 |
{(Is/Are)/As of December 31, {YEAR}, (were/was)} (READ NAMES BELOW) attending school either part-time or full-time? |
2013 |
|
||
RE107 |
Omitted; combine with RE108. |
2010 |
Who {is/was} attending school either part-time or full-time {on December 31, {YEAR}}? |
2013 |
|
||
RE108 |
Revised to include RE107 and RE107. |
2010 |
{[Earlier you mentioned (PERSON) was living away at school in grades 1-12.]} {Is/Was} (PERSON) attending school part-time or full-time? |
2013 |
{[Earlier you mentioned {you/{PERSON}} {were/was} living away at school in grades 1-12.]} {{Are/Is}}/As of December 31, {YEAR}, {were/was}} {you/{PERSON}} attending school full-time, part-time, or not attending school at all? |
||
Help Text
RE103 |
Replace definition of regular school with level of school. Updated category names. |
2010 |
REGULAR
SCHOOL -- A school that advances a person toward an elementary or
high school diploma, or a college or professional school
degree. |
2013 |
LEVEL
OF SCHOOL -- |
||
Help Text
RE104 |
Omitted. |
2010 |
HAVE
HIGH SCHOOL DIPLOMA -- A certificate that verifies that a person
has successfully completed the required courses of a high school
curriculum. By ‘have a high school diploma’, we mean
did the person graduate from high school rather than literally do
they have the document bearing record of graduation. |
2013 |
|
||
Help Text
RE105 |
Omitted. |
2010 |
BACHELOR’S
DEGREE -- An educational degree given by a college or university
to a person who has completed a four-year course or its
equivalent in the humanities or related studies (B.A.) or in the
sciences (B.S.). |
2013 |
|
Review of Employment Information (RJ)
In Rounds 2 through 5, the Review of Employment Information reviews employment information for any current job identified during the previous round. It collects updated information on job status, salary where changes in wages occur, full- or part-time work, health insurance benefits, and size of employment establishment if the jobholder is self employed. Questions are asked about whether the person's job was temporary or seasonal, and additional questions are asked about health insurance, including whether it was offered to the person, whether it was offered to any employee, and why the person was not eligible.
Changes: None
Satisfaction with Health Plan (SP)
The Satisfaction with Health Plan section collects satisfaction information for private insurance, Medigap, Medicare managed care programs, Medicaid/SCHIP, and TRICARE insurance. The information collected includes ease of access to medical care, need to seek approval for medical treatments and delays in care experienced while waiting for approval, ease of access to understandable plan information and repercussions of poor access, need to complete paperwork and problems filling out paperwork, and an overall rating of the health plan.
Item |
Changes |
Year |
Text |
SP01 |
Revised to include time frame. |
2010 |
The next questions ask about (POLICYHOLDER)’s (and other family members’) experience(s) with {NAME OF INSURER BEING LOOPED ON}, that is, (POLICYHOLDER)’s {hospital and physician/Medicare Supplement or Medigap} coverage through (ESTABLISHMENT). |
2013 |
We are going to ask you to rate {your/{POLICYHOLDER}’s} (and other family members’) experience(s) with {NAME OF INSURER BEING LOOPED ON}, that is, {your/his/her} {hospital and physician/Medicare Supplement or Medigap} coverage through {ESTABLISHMENT} In answering these questions, please think about your experiences over the last 12 months. |
Time
Period Covered Detail (HQ)
This section clarifies the timeframe for which each person was covered by each reported health insurance policy. It links to the Health Insurance (HX), Private Health Insurance Detail (HP), and Old Public Related Insurance (PR) sections.
Changes: None
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | DHHS |
File Modified | 0000-00-00 |
File Created | 2021-01-30 |