Routing for UAS537
intro1 (intro)
Patients’ experiences and preferences in health care are an important area of research. Advances in technology have allowed doctors, nurses, and other health care providers to interact with their patients in new ways. In this survey, we will ask you questions about your experience with health care visits and billing in the last year. We will also ask about your preferences for reimagined health care and care beyond medical problems.
util_intro
In this section, you will be asked several questions about recent medical care you may have received.
droffice (how many times seen health care in past 12 months)
In the past 12 months, how many times have you seen a doctor or other health care professional at a doctor’s office or a clinic? Do not include times when you were hospitalized overnight, visits to the emergency room, home visits, or telephone calls.
1 0 times
2 1 to 3 times
3 4 to 6 times
4 7 to 9 times
5 10 or more times
hospital (been a patient in hospital since March 2020)
Since the COVID-19 pandemic began in the U.S. in March 2020, have you been a patient in the hospital over night?
1 Yes, I have been a patient in the hospital
2 No, I have avoided or postponed medical care that I need in the hospital
3 No, I have not needed medical care in the hospital
if hospital = 2 then
avoidhosp_covid (was med care put off: worried about getting Covid)
Was the medical care you needed in the hospital put off for any of the following reasons?
My medical care in the hospital has been put off because I am worried about getting infected with the coronavirus that causes COVID-19.
1 (YES) Yes
2 (NO) No
avoidhosp_dr (was med care put off: doctor discourages coming to hospital)
Was the medical care you needed in the hospital put off for any of the following reasons?
My medical care in the hospital has been put off because my doctor discourages me from coming to the hospital.
1 (YES) Yes
2 (NO) No
avoidhosp_resched (was med care put off: doctor unavailable and rescheduled)
Was the medical care you needed in the hospital put off for any of the following reasons?
My medical care in the hospital has been put off because my doctor was unavailable and rescheduled my procedure.
1 (YES) Yes
2 (NO) No
avoidhosp_cost (was med care put off: cannot afford)
Was the medical care you needed in the hospital put off for any of the following reasons?
My medical care in the hospital has been put off because I cannot afford my co-pay or deductible.
1 (YES) Yes
2 (NO) No
End of if
avoidcare_cost (anytime couldn't afford med care since March 2020)
Since the COVID-19 pandemic began in the U.S. in March 2020, was there any time when you needed any type of medical care, but did not get it because you couldn’t afford it?
1 (YES) Yes
2 (NO) No
Group of questions presented on the same screen
truefalse_intro
Thinking about your experiences with medical care, please answer true or false for the following statements.
Subgroup of questions
afford_services (T or F: I can currently afford health care services)
I can currently afford to pay for health care services.
1 True
2 False
transport (T or F: if needed I could access transportation to healthcare facility)
If needed, I could access transportation to a healthcare facility (driving your own car, using public transportation, etc.).
1 True
2 False
End of subgroup of questions
End of group of questions
scale_intro
For the next four questions, please rate your experience with visits to your doctor’s office, clinic, hospital, or other provider.
Group of questions presented on the same screen
experience_hco (rating of experience with health care organization used most often)
In the last 12 months, how would you rate your experience overall with the health care organization you use most often?
slider_script0_100
Please enter a number between 0 and 100.
End of group of questions
Group of questions presented on the same screen
safe_pcp (rating of healthcare experience: feeling safe visiting)
Do you feel safe getting care from your primary care doctor or specialist at their office?
slider_script0_10
Please enter a number between 0 and 10.
End of group of questions
Group of questions presented on the same screen
safe_outp (rating of healthcare experience: feel safe getting outpatient services)
Would you feel safe getting a procedure, treatment, or imaging done at a medical office for outpatient services?
slider_script0_10
Please enter a number between 0 and 10.
End of group of questions
Group of questions presented on the same screen
safe_hospital (rating of healthcare experience: feel safe during hospital stay)
Would you feel safe during a hospital stay?
slider_script0_10
Please enter a number between 0 and 10.
End of group of questions
billing_intro
In this section, you will be asked questions about recent medical bills you may have received.
hcb_ever (received med bill you didn't agree with or couldn't afford in past 12 mos)
In the past 12 months, have you or someone in your household ever received a medical bill that you didn’t agree with or couldn’t afford to pay?
1 (YES) Yes
2 (NO) No
if hcb_ever = 1 then
hcb_prob (problems with most concerning bill)
Thinking about the bill that was most concerning to you, what was the problem with the bill?
Check all that apply.
1 Could not afford to pay the bill
2 Felt the bill was unfairly high
3 Felt the bill was too high because of a mistake
4 The bill seemed confusing
Group of questions presented on the same screen
hcb_type (most concerning bill: type of health care service)
Thinking about the bill that was most concerning to you, what type of health care service was this for?
1 Hospital
2 Doctor office visit
3 Emergency Room (ER) or urgent care center
4 Pharmacy
5 X-ray, MRI, or scan
6 Laboratory
7 Other; describe:
hcb_type_other (type of health care service of most concerning bill--other specify)
STRING
End of group of questions
hcb_reach (whether someone reached out to billing office)
Thinking about the bill that was most concerning to you, did you or someone else reach out to the billing office?
1 (YES) Yes
2 (NO) No
if hcb_reach = 2 then
Group of questions presented on the same screen
hcb_whynot (why no one reached out to billing office)
Why didn’t anyone reach out to the billing office about this bill?
Select all that apply.
1 Felt uncomfortable reaching out
2 Didn’t have time
3 Didn’t know how
4 Didn’t think it would change the bill
5 Worried it would harm my medical care in the future
6 Other; describe:
hcb_whynot_other (why no one reached out to billing office--other specify)
STRING
End of group of questions
elseif hcb_reach = 1 then
hcb_who (who reached out to billing office)
Who communicated with the billing office?
Check all that apply.
1 Me
2 Another household member
3 A friend or relative
4 Somebody from an advocacy organization (for example, Dollar For)
if 1 in hcb_who then
Group of questions presented on the same screen
hcb_intro
Please indicate how much you agree or disagree with the following statements:
Subgroup of questions
hcb_comfort (Agree/disagree: comfortable communicating with billing office)
Overall, I felt comfortable communicating with the billing office myself.
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
hcb_respect (Agree/disagree: felt people at billing office treated me with respect)
Overall, I felt the people working at the billing office treated me with respect.
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
End of subgroup of questions
End of group of questions
Group of questions presented on the same screen
hcb_how (how communicated with billing office)
How did you communicate with the billing office?
Check all that apply.
1 Telephone
2 Letters
3 Emails
4 Other; describe:
hcb_how_other (how communicated with billing office--other specify)
STRING
End of group of questions
hcb_time (total amount of time spent with billing office)
What was the total amount of time you spent communicating with the billing office?
1 Less than 1 hour
2 1-2 hours
3 2-5 hours
4 More than 5 hours
End of if
Group of questions presented on the same screen
hcb_reason (reason reached out to billing office)
Thinking about when you or someone else reached out to the billing office, what was the reason?
Check all that apply.
1 Ask questions about the services
2 Ask questions about the price
3 Ask about financial assistance
4 Negotiate to pay less
5 Set up a payment plan
6 Other; describe:
hcb_reason_other (reason reached out to billing office--other specify)
STRING
End of group of questions
hcb_result (results of communication with billing office)
What were the results of the communication with the billing office?
Check all that apply.
1 Understand the bill better now
2 Bill was corrected
3 Set up a payment plan
4 Got financial assistance
5 Price was dropped
6 Bill was cancelled
7 Nothing changed
8 This problem is not solved yet
End of if
End of if
tech_intro
This section has several questions. We will ask you about your experience with virtual health care and other technology applications in the healthcare system.
th_yr (had telehealth visit in past 12 mos)
A telehealth visit is a virtual visit with your doctor or other health care provider where you are interacting with your provider by video, telephone, or an online portal. Have you had a telehealth visit with your health care provider in the past 12 months?
1 (YES) Yes
2 (NO) No
if th_yr = 1 then
th_type (type of provider during last telehealth visit)
What type of provider did you interact with for your most recent telehealth visit?
1 Urgent care, on demand
2 Primary care doctor for a preventive/wellness check-up
3 Existing specialist
4 New specialist
5 Psychiatrist
6 Mental health or behavioral health provider
Fill code of question 'FLProvider' executed
th_modality (modality of most recent telehealth visit)
Thinking about your most recent telehealth visit with [urgent care, on demand/a primary care doctor for a preventive/wellness check-up/an existing specialist/a new specialist/a psychiatrist/a mental health or behavioral health provider/a healthcare provider], what kind of interaction best describes this visit?
1 Video visit
2 Telephone/audio only (no video)
3 Online chat or other exchange (no video and no audio)
4 Other
th_satisfied (how satisfied with most recent telehealth visit)
Thinking about your most recent telehealth visit with [urgent care, on demand/a primary care doctor for a preventive/wellness check-up/an existing specialist/a new specialist/a psychiatrist/a mental health or behavioral health provider/a healthcare provider], how much do you agree with the following statement:
Overall, I was satisfied with my telehealth visit.
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
th_satisfied_same (most recent telehealth visit as satisfying as an in-person visit)
Thinking about your most recent telehealth visit with [urgent care, on demand/a primary care doctor for a preventive/wellness check-up/an existing specialist/a new specialist/a psychiatrist/a mental health or behavioral health provider/a healthcare provider], how much do you agree with the following statement:
My telehealth visit was as satisfactory as an in-person visit would have been.
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
End of if
interest_pcpv (how interested to see doctor over video for refills)
How interested would you be to see your primary care doctor over video for certain visits, like prescription refills?
1 Very interested
2 Somewhat interested
3 Neutral
4 A little interested
5 Not at all interested
interest_phev (how likely to video visit during public health emergency)
How likely would you be to have a video visit with your doctor during a public health emergency?
1 Very likely
2 Somewhat likely
3 Neither likely or unlikely
4 Somewhat unlikely
5 Very unlikely
safe_records (how confident med records are safe)
How confident are you that your medical records are safe from being seen by people who aren’t permitted to see them?
1 Very confident
2 Somewhat confident
3 Not confident
4 Not sure
perceptions_intro
This section has 19 questions pertaining to social needs and coordination of social services that can help you lead a healthy lifestyle.
sn_needs (social needs in last 12 months)
Within the last 12 months, have you personally had any of the following social needs?
1 Not being able to find or afford healthy food
2 Housing problems or homelessness
3 Not being able to find or afford transportation
4 Not being able to afford basic expenses
5 Being alone or isolated from friends, family, or others
6 Trouble understanding written medical information
7 I haven’t personally had any of these needs
Group of questions presented on the same screen
sn_ask (needs doctors/nurses should ask all patients)
Which of the needs below should doctors or nurses ask all patients about?
Check all that apply.
1 Not being able to find or afford healthy food
2 Housing problems or homelessness
3 Not being able to find or afford transportation
4 Not being able to afford basic expenses
5 Being alone or isolated from friends, family, or others
6 Trouble understanding written medical information
7 Other (Please specify):
8 None of the above
sn_ask_other (needs doctors/nurses should ask all patients--other specify)
STRING
End of group of questions
sn_help (needs doctors/nurses should help with if they want to)
Which needs should doctors or nurses help their patients with, if they want help?
Check all that apply.
1 Not being able to find or afford healthy food
2 Housing problems or homelessness
3 Not being able to find or afford transportation
4 Not being able to afford basic expenses
5 Being alone or isolated from friends, family, or others
6 Trouble understanding written medical information
7 None of the above
sn_druse (Agree/disagree: support doctor using social needs info)
For the next three questions, please indicate how much you agree or disagree with the following statements:
“I support my doctor using social needs information to improve my care.”
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
sn_insbudget (agree/disagree: health insurance plan should help patients with social needs)
“My health insurance plan should dedicate part of its budget to help patients with their social needs.”
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
sn_inscost (agree/disagree: health insurance should help even if it increases cost)
“My health insurance plan should help patients with their social needs even if that could increase my health care costs.”
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
interest_intro
Often healthy living is managed outside of the hospital or doctor’s office. Social services provide resources for the hospital-to-home transition and managing health at home. Please indicate your level of interest in the following services offered by community-based organizations that partner with hospitals and other medical providers.
interest_meals (How interested: to receive meal deliveries after hospitalization)
How interested would you be to receive meal deliveries after a hospitalization?
1 Very interested
2 Somewhat interested
3 A little interested
4 Not at all interested
interest_transport (How interested: to receive transportation home after hosp.)
How interested would you be to receive transportation to your home after a hospitalization?
1 Very interested
2 Somewhat interested
3 A little interested
4 Not at all interested
interest_coordination (How interested: to receive care coordination)
How interested would you be to receive care coordination for follow-up appointments, home health care, or rehabilitation visits after a hospitalization?
1 Very interested
2 Somewhat interested
3 A little interested
4 Not at all interested
interest_mh (How interested: to receive mental health counseling)
How interested would you be to receive resources and referrals for mental health counseling from your doctor?
1 Very interested
2 Somewhat interested
3 A little interested
4 Not at all interested
interest_finances (How interested: to receive financial support from doctor)
How interested would you be to receive resources and referrals for financial support from your doctor?
1 Very interested
2 Somewhat interested
3 A little interested
4 Not at all interested
interest_legal (How interested: to receive legal support from doctor)
How interested would you be to receive resources and referrals for legal support from your doctor?
1 Very interested
2 Somewhat interested
3 A little interested
4 Not at all interested
interest_housing (How interested: to receive shelter/housing support from doctor)
How interested would you be to receive resources and referrals for shelter/housing support from your doctor?
1 Very interested
2 Somewhat interested
3 A little interested
4 Not at all interested
interest_food (How interested: to receive resources for food banks from doctor)
How interested would you be to receive resources and referrals for food banks from your doctor?
1 Very interested
2 Somewhat interested
3 A little interested
4 Not at all interested
interest_substance (How interested: to receive referrals for substance abuse programs from doctor)
How interested would you be to receive resources and referrals for substance abuse programs from your doctor?
1 Very interested
2 Somewhat interested
3 A little interested
4 Not at all interested
interest_childcare (How interested: to referrals for childcare from doctor)
How interested would you be to receive resources and referrals for childcare from your doctor?
1 Very interested
2 Somewhat interested
3 A little interested
4 Not at all interested
interest_mgmt (How interested: to receive referrals for chronic cond. mgmt from doctor)
How interested would you be to receive resources and referrals for chronic condition management programs from your doctor?
1 Very interested
2 Somewhat interested
3 A little interested
4 Not at all interested
hrsntrust_hosp (how much trust after hospitalization: in hospitals)
How much do you trust hospitals to coordinate health-related services such as meal delivery, transportation, and medical care coordination after a hospitalization?
1 Complete trust
2 Quite a bit of trust
3 Little trust
4 No trust at all
5 Not sure
hrsntrust_ins (how much trust after hospitalization: in health insurance companies)
How much do you trust health insurance companies to coordinate health-related services such as meal delivery, transportation, and medical care coordination after a hospitalization?
1 Complete trust
2 Quite a bit of trust
3 Little trust
4 No trust at all
5 Not sure
home_intro
Connected electronic devices have made some aspects of health care available in the home. Home health care is when doctors or nurses come to your home with medical equipment or have you wear a digital tracker to obtain your medical data over a time period.
Please click Next to continue.
home_iv (where prefer: outpatient IV therapy and infusions)
Where would you prefer to have outpatient intravenous therapy and infusions?
1 In the doctor's office or hospital
2 In my home
home_ot (where prefer: occupational therapy)
Where would you prefer to have occupational therapy?
1 In the doctor's office or hospital
2 In my home
home_pt (where prefer: rehab or physical therapy)
Where would you prefer to have rehabilitation or physical therapy?
1 In the doctor's office or hospital
2 In my home
home_chronic (where prefer: chronic condition monitoring)
Where would you prefer to have chronic condition monitoring for diabetes, high blood pressure, asthma, heart failure, or breathing problems?
1 In the doctor's office or hospital
2 In my home
home_labs (where prefer: blood draws, X-rays, ultrasounds, etc)
Where would you prefer to have blood draws, X-rays, ultrasounds, and heart monitoring?
1 In the doctor's office or hospital
2 In my home
hah_intro (hosp at home intro text)
Hospital-at-home medical care has been around for a long time, where doctors and nurses come to the patient’s home instead of being treated at the hospital. There are frequent visits by doctors, nurses, physical and occupational therapists, social workers, equipment technicians, pharmacists, and meal deliveries. Patients are monitored at home and given a tablet with a simple button that connects to a care team via telehealth. Many routine infections, chronic disease episodes, emergency medicine, cancer care, COVID-19 care, and transfusions can be treated at home.
Please click Next to continue.
Group of questions presented on the same screen
hah_agree_intro
Please indicate your level of agreement with each statement.
haha_choose (agree/disagree: choose to have hospital level care at home)
If I had a choice, I would choose to have hospital-level care at home.
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
End of group of questions
hahe_recover (agree/disagree: People recover faster at home than in the hospital)
People recover faster at home than in the hospital.
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
hahe_equiv (agree/disagree: Medical care at home can be as good as medical care in the hospital)
Medical care at home can be as good as medical care in the hospital.
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
hahs_long (agree/disagree: emergency at home would take too long for medical care to arrive)
If I had an emergency at home, it would take too long for medical care to arrive.
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
hahs_lesslikely (agree/disagree: at home less likely to get confused or catch an infection)
At home, I would be less likely to get confused or catch an infection in the hospital.
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
hahs_safe (agree/disagree: I would feel safe being treated at home)
I would feel safe being treated at home.
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
hahc_comfort (agree/disagree: more comfortable being treated at home than in the hospital)
I would be more comfortable being treated at home than in the hospital.
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
hahc_bother (agree/disagree: would bother me (or family) for nurses/doctors coming into home)
It would bother me (or my family) to have nurses and doctors coming into my home.
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
hahs_complication (agree/disagree: hospital treatment can result in complications)
Treatment in the hospital can result in complications, such as skin problems, falls, infections, and confusion.
1 Strongly agree
2 Agree
3 Neutral
4 Disagree
5 Strongly disagree
Group of questions presented on the same screen
hah_yesno_intro
Please indicate your preference for hospital-level care at home.
hah_pneumonia (Yes/No if had choice to have hosp-level care for: pneumonia)
If you had a choice, would you choose to have hospital-level care at home for community-acquired pneumonia?
1 (YES) Yes
2 (NO) No
End of group of questions
hah_asthma (Yes/No if had choice to have hosp-level care for: asthma)
If you had a choice, would you choose to have hospital-level care at home for asthma?
1 (YES) Yes
2 (NO) No
hah_hf (Yes/No if had choice to have hosp-level care for: heart failure)
If you had a choice, would you choose to have hospital-level care at home for chronic heart failure?
1 (YES) Yes
2 (NO) No
hah_copd (Yes/No if had choice to have hosp-level care for: COPD)
If you had a choice, would you choose to have hospital-level care at home for chronic obstructive pulmonary disease (COPD)?
1 (YES) Yes
2 (NO) No
hah_bp (Yes/No if had choice to have hosp-level care for: hbp)
If you had a choice, would you choose to have hospital-level care at home for diabetes-related or high blood pressure-related episodes?
1 (YES) Yes
2 (NO) No
hah_cancer (Yes/No if had choice to have hosp-level care for: cancer)
If you had a choice, would you choose to have hospital-level care at home for cancer?
1 (YES) Yes
2 (NO) No
hah_covid (Yes/No if had choice to have hosp-level care for: covid-19)
If you had a choice, would you choose to have hospital-level care at home for COVID-19?
1 (YES) Yes
2 (NO) No
hah_transfusion (Yes/No if had choice to have hosp-level care for: transfusions)
If you had a choice, would you choose to have hospital-level care at home for transfusions?
1 (YES) Yes
2 (NO) No
hah_pain (Yes/No if had choice to have hosp-level care for: pain management)
If you had a choice, would you choose to have hospital-level care at home for pain management?
1 (YES) Yes
2 (NO) No
recovery (post-surgery recovery preference: home or hospital)
At-home recovery after a surgery in the hospital is available for some conditions. Doctors and nurses monitor the patient’s recovery via home, telephone, and/or home visits after hospital discharge.
Would you prefer to go home from the hospital earlier and receive post-operative care in your home or stay in the hospital for post-operative recovery?
1 I would prefer to go home earlier and receive post-operative care in my home
2 I would prefer to stay in the hospital for recovery
3 No preference
caregiver_intro
Family caregivers have an important role in hospital-at-home care. The medical care team provides instructions and virtual support for medical tasks when the nurse is not in the home.
Think about if a family member was eligible to receive hospital-at-home care and you were the caregiver. Please answer how likely you would be to complete these tasks for your loved one without a nurse in the home.
caregiver_wound (likelihood to complete at home: wound care)
If you had instructions and virtual support from nurses, how likely is it that you would provide wound care for your family member who was undergoing hospital-at-home care on your own?
1 Very likely
2 Somewhat likely
3 Neither likely or unlikely
4 Somewhat unlikely
5 Very unlikely
caregiver_monitor (likelihood to complete at home: monitor med equipment)
If you had instructions and virtual support from nurses, how likely is it that you would monitor medical equipment for your family member who was undergoing hospital-at-home care on your own?
1 Very likely
2 Somewhat likely
3 Neither likely or unlikely
4 Somewhat unlikely
5 Very unlikely
caregiver_meds (likelihood to complete at home: manage meds)
If you had instructions and virtual support from nurses, how likely is it that you would manage medication on a schedule for your family member who was undergoing hospital-at-home care on your own?
1 Very likely
2 Somewhat likely
3 Neither likely or unlikely
4 Somewhat unlikely
5 Very unlikely
caregiver_iv (likelihood to complete at home: change IV bags)
If you had instructions and virtual support from nurses, how likely is it that you would change intravenous (IV) bags for your family member who was undergoing hospital-at-home care on your own?
1 Very likely
2 Somewhat likely
3 Neither likely or unlikely
4 Somewhat unlikely
5 Very unlikely
caregiver_pain (likelihood to complete at home: follow pain mgmt plans)
If you had instructions and virtual support from nurses, how likely is it that you would follow pain management plans for your family member who was undergoing hospital-at-home care on your own?
1 Very likely
2 Somewhat likely
3 Neither likely or unlikely
4 Somewhat unlikely
5 Very unlikely
caregiver_cath (likelihood to complete at home: change catheter bags)
If you had instructions and virtual support from nurses, how likely is it that you would change catheter bags for your family member who was undergoing hospital-at-home care on your own?
1 Very likely
2 Somewhat likely
3 Neither likely or unlikely
4 Somewhat unlikely
5 Very unlikely
caregiver_tubes (likelihood to complete at home: change feeding tubes)
If you had instructions and virtual support from nurses, how likely is it that you would change feeding tubes for your family member who was undergoing hospital-at-home care on your own?
1 Very likely
2 Somewhat likely
3 Neither likely or unlikely
4 Somewhat unlikely
5 Very unlikely
satisfaction_intro
This section has seven questions. We will ask you about your satisfaction with your current health plan, access to care, and your health status.
hp_satisfied (how satisfied with current health insurance plan)
Overall, how satisfied are you with your current health insurance plan?
1 Very satisfied
2 Somewhat satisfied
3 Neither satisfied nor dissatisfied
4 Somewhat dissatisfied
5 Very dissatisfied
Fill code of question 'FLsf_satisfied' executed
if hp_satisfied = 1 or hp_satisfied = 2 then
Group of questions presented on the same screen
sf_why_satisfied (why satisfied with health insurance)
Why are you [very satisfied/somewhat satisfied/neither satisfied nor dissatisfied/somewhat dissatisfied/very dissatisfied] with your current health insurance plan?
Check all that apply.
1 Providers I want to go to are covered
2 Able to get timely appointments
3 Low out-of-pocket spending
4 Low premiums
5 Good customer service
6 Claims are paid quickly
7 No problems or issues
8 Good coverage
9 Other, specify:
sf_why_satisfied_text (why satisfied with health insurance--other specify)
STRING
End of group of questions
elseif hp_satisfied = 3 or hp_satisfied = 4 or hp_satisfied = 5 then
Group of questions presented on the same screen
sf_why_not_satisfied (why not satisfied with health insurance)
Why are you [very satisfied/somewhat satisfied/neither satisfied nor dissatisfied/somewhat dissatisfied/very dissatisfied] with your current health insurance plan?
Check all that apply.
1 Providers I want to go are not covered
2 Unable to get timely appointments
3 High out-of-pocket spending
4 High premiums
5 Poor customer service
6 My claims are rejected
7 My prescriptions are not covered
8 Poor medical coverage
9 Other, specify:
sf_why_not_satisfied_text (why not satisfied with health insurance--other specify)
STRING
End of group of questions
End of if
quality_satisfied (how satisfied with health care: quality)
How satisfied are you with the quality of your health care?
1 Very satisfied
2 Somewhat satisfied
3 Neither satisfied nor dissatisfied
4 Somewhat dissatisfied
5 Very dissatisfied
cost_satisfied (how satisfied with health care: cost)
How satisfied are you with the cost of your health care?
1 Very satisfied
2 Somewhat satisfied
3 Neither satisfied nor dissatisfied
4 Somewhat dissatisfied
5 Very dissatisfied
convenience_satisfied (how satisfied with health care: convenience)
How satisfied are you with the convenience of your health care?
1 Very satisfied
2 Somewhat satisfied
3 Neither satisfied nor dissatisfied
4 Somewhat dissatisfied
5 Very dissatisfied
health (rating of overall health)
In general, how would you rate your overall health?
1 Excellent
2 Very good
3 Good
4 Fair
5 Poor
mental_health (rating of overall mental/emotional health)
In general, how would you rate your overall mental or emotional health?
1 Excellent
2 Very good
3 Good
4 Fair
5 Poor
Group of questions presented on the same screen
cci_intro
As far as you know, do you have any of the following health conditions at the present time?
Subgroup of questions
cci_asthma (have condition: asthma, emphysema, bronchitis)
Asthma, emphysema, or chronic bronchitis
1 (YES) Yes
2 (NO) No
cci_arth (have condition: arthritis or rheumatism)
Arthritis or rheumatism
1 (YES) Yes
2 (NO) No
cci_cancer (have condition: Cancer, diagnosed in the past 3 years)
Cancer, diagnosed in the past 3 years
1 (YES) Yes
2 (NO) No
cci_diab (have condition: Diabetes)
Diabetes
1 (YES) Yes
2 (NO) No
cci_digestive (have condition: digestive problems)
Digestive problems (such as ulcer, colitis, or gallbladder disease)
1 (YES) Yes
2 (NO) No
cci_heart (have condition: heart trouble)
Heart trouble (such as angina, congestive heart failure, or coronary artery disease)
1 (YES) Yes
2 (NO) No
cci_immune (have condition: Immunocompromised condition)
Immunocompromised condition
1 (YES) Yes
2 (NO) No
cci_kidney (have condition: Kidney disease)
Kidney disease
1 (YES) Yes
2 (NO) No
cci_liver (have condition: liver problems)
Liver problems (such as cirrhosis)
1 (YES) Yes
2 (NO) No
cci_stroke (have condition: stroke)
Stroke
1 (YES) Yes
2 (NO) No
cci_text1 (have condition: other med problems #1)
Other medical problem (please write in):
1 (YES) Yes
2 (NO) No
cci_text1_problem (other medical problem--write-in #1)
STRING
cci_text2 (have condition: other med problems #2)
Other medical problem (please write in):
1 (YES) Yes
2 (NO) No
cci_text2_problem (other medical problem--write-in #2)
STRING
cci_text3 (have condition: other med problems #3)
Other medical problem (please write in):
1 (YES) Yes
2 (NO) No
cci_text3_problem (other medical problem--write-in #3)
STRING
End of subgroup of questions
conditions_js
Please write a brief description of the other medical problem(s) you have at the present time.
Please select the Yes answer choice to the right if you specified another medical problem in the text box.
End of group of questions
if cci_asthma = 1 or cci_arth = 1 or cci_cancer = 1 or cci_diab = 1 or cci_digestive = 1 or cci_heart = 1 or cci_immune = 1 or cci_kidney = 1 or cci_liver = 1 or cci_stroke = 1 or cci_text1 = 1 or cci_text2 = 1 or cci_text3 = 1 then
Group of questions presented on the same screen
cci_intro_tx
Do you receive treatment for any of the conditions you have at the present time?
Subgroup of questions
if cci_asthma = 1 then
cci_asthma_tx (treatment for: asthma, emphysema, bronchitis)
Asthma, emphysema, or chronic bronchitis
1 (YES) Yes
2 (NO) No
End of if
if cci_arth = 1 then
cci_arth_tx (treatment for: arthritis or rheumatism)
Arthritis or rheumatism
1 (YES) Yes
2 (NO) No
End of if
if cci_cancer = 1 then
cci_cancer_tx (treatment for: Cancer, diagnosed in the past 3 years )
Cancer, diagnosed in the past 3 years
1 (YES) Yes
2 (NO) No
End of if
if cci_diab = 1 then
cci_diab_tx (treatment for: diabetes)
Diabetes
1 (YES) Yes
2 (NO) No
End of if
if cci_digestive = 1 then
cci_digestive_tx (treatment for: digestive problems)
Digestive problems (such as ulcer, colitis, or gallbladder disease)
1 (YES) Yes
2 (NO) No
End of if
if cci_heart = 1 then
cci_heart_tx (treatment for: heart trouble)
Heart trouble (such as angina, congestive heart failure, or coronary artery disease)
1 (YES) Yes
2 (NO) No
End of if
if cci_immune = 1 then
cci_immune_tx (treatment for: immunocompromised condition)
Immunocompromised condition
1 (YES) Yes
2 (NO) No
End of if
if cci_kidney = 1 then
cci_kidney_tx (treatment for: kidney disease)
Kidney disease
1 (YES) Yes
2 (NO) No
End of if
if cci_liver = 1 then
cci_liver_tx (treatment for: liver problems)
Liver problems (such as cirrhosis)
1 (YES) Yes
2 (NO) No
End of if
if cci_stroke = 1 then
cci_stroke_tx (treatment for: stroke)
Stroke
1 (YES) Yes
2 (NO) No
End of if
if cci_text1 = 1 then
cci_text1_tx (treatment for: other med problems #1)
[other medical problem--write-in #1[]]
1 (YES) Yes
2 (NO) No
End of if
if cci_text2 = 1 then
cci_text2_tx (treatment for: other med problems #2)
[other medical problem--write-in #2[]]
1 (YES) Yes
2 (NO) No
End of if
if cci_text3 = 1 then
cci_text3_tx (treatment for: other med problems #3)
[other medical problem--write-in #3[]]
1 (YES) Yes
2 (NO) No
End of if
End of subgroup of questions
End of group of questions
Group of questions presented on the same screen
cci_intro_la
Do any of the conditions you have at the present time limit your activities?
Subgroup of questions
if cci_asthma = 1 then
cci_asthma_la (limits activity: asthma, emphysema, bronchitis)
Asthma, emphysema, or chronic bronchitis
1 (YES) Yes
2 (NO) No
End of if
if cci_arth = 1 then
cci_arth_la (limits activity: arthritis or rheumatism)
Arthritis or rheumatism
1 (YES) Yes
2 (NO) No
End of if
if cci_cancer = 1 then
cci_cancer_la (limits activity: Cancer, diagnosed in the past 3 years)
Cancer, diagnosed in the past 3 years
1 (YES) Yes
2 (NO) No
End of if
if cci_diab = 1 then
cci_diab_la (limits activity: diabetes)
Diabetes
1 (YES) Yes
2 (NO) No
End of if
if cci_digestive = 1 then
cci_digestive_la (limits activity: digestive problems)
Digestive problems (such as ulcer, colitis, or gallbladder disease)
1 (YES) Yes
2 (NO) No
End of if
if cci_heart = 1 then
cci_heart_la (limits activity: heart trouble)
Heart trouble (such as angina, congestive heart failure, or coronary artery disease)
1 (YES) Yes
2 (NO) No
End of if
if cci_immune = 1 then
cci_immune_la (limits activity: immunocompromised condition)
Immunocompromised condition
1 (YES) Yes
2 (NO) No
End of if
if cci_kidney = 1 then
cci_kidney_la (limits activity: kidney disease)
Kidney disease
1 (YES) Yes
2 (NO) No
End of if
if cci_liver = 1 then
cci_liver_la (limits activity: liver problems)
Liver problems (such as cirrhosis)
1 (YES) Yes
2 (NO) No
End of if
if cci_stroke = 1 then
cci_stroke_la (limits activity: stroke)
Stroke
1 (YES) Yes
2 (NO) No
End of if
if cci_text1 = 1 then
cci_text1_la (limits activity: other med problems #1)
[other medical problem--write-in #1[]]
1 (YES) Yes
2 (NO) No
End of if
if cci_text2 = 1 then
cci_text2_la (limits activity: other med problems #2)
[other medical problem--write-in #2[]]
1 (YES) Yes
2 (NO) No
End of if
if cci_text3 = 1 then
cci_text3_la (limits activity: other med problems #3)
[other medical problem--write-in #3[]]
1 (YES) Yes
2 (NO) No
End of if
End of subgroup of questions
End of group of questions
End of if
CS_001 (HOW PLEASANT INTERVIEW)
Could you tell us how interesting or uninteresting you found the questions in this survey?
1 Very interesting
2 Interesting
3 Neither interesting nor uninteresting
4 Uninteresting
5 Very uninteresting
CS_003 (comments)
Do you have any other comments on the survey? Please type these in the box below. (If you have no comments, please click next to complete this survey.)
STRING