MEPS Quality (Priority Conditions) Supplement

THE PC SECTION IS ASKED IN ROUNDS 3 AND 5 ONLY.
IF IT IS ROUND 1, 2, OR 4, CONTINUE TO THE NEXT SECTION.

CONTEXT HEADER DISPLAY INSTRUCTIONS:
DISPLAY PERS.FULLNAME

NOTE: CURRENTLY THE QUALITY SUPPLEMENT CONTAINS QUESTIONS FOR PERSONS FOR WHOM DIABETES OR ASTHMA WAS REPORTED IN THE PRIORITY CONDITION ENUMERATION (PE) SECTION. OTHER QUALITY QUESTIONS ARE LOCATED IN THE PREVENTIVE CARE (AP) SECTION. HOWEVER, THE QUALITY SECTION COULD INCLUDE QUESTIONS FOR THE OTHER PRIORITY CONDITIONS AS THEY ARE NEEDED IN FUTURE PANELS.

IF PERSON IS => 18 YEARS OF AGE OR IN AGE CATEGORIES 4-9 AND IF PERSON IS A KEY RU MEMBER AND IF ‘DIABETES’ ON PERSON’S- MEDICAL-CONDITIONS-ROSTER AND FLAGGED AS CREATED IN THE PE SECTION (IN ANY ROUND), CONTINUE WITH BOX_03

OTHERWISE, GO TO BOX_04

IF PERSON BEING ASKED ABOUT IS FLAGGED AS ‘DECEASED’ FOR THE CURRENT ROUND, GO TO BOX_04

OTHERWISE, CONTINUE WITH PC02A

{During an earlier interview, it/It} was mentioned that {you/{PERSON}} {have/has} diabetes. To obtain more information on the care of adults with diabetes, we have a short questionnaire for {you/him/her}.

DISPLAY ‘During an earlier interview, it’ IF DIABETES WAS NOT CREATED DURING THE CURRENT ROUND. DISPLAY ‘It’ IF DIABETES CREATED DURING THE CURRENT ROUND.

DISPLAY ‘NOT’ IN BOLD IN THE ANSWER TEXT. IF ‘PERSON DOES NOT HAVE DIABETES’ IS SELECTED, THIS DOES NOT RE-SET THE DATA FROM THE PE SECTION (PRND.PCDIABET). THE RESPONSE TO PC02A WILL DETERMINE WHETHER PC03 IS ASKED AND WHETHER THERE IS DCS FOLLOW-UP FOR THIS PERSON IN THE CL SECTION

DOB: {MM/DD/YYYY} PID: {PID} RU ID: {RUID-7}
STATUS: {CURRENT/INSTITUTIONALIZED}

DETERMINE IF SELF OR PROXY DIABETES CARE SUPPLEMENT (DCS) SHOULD BE DISTRIBUTED:

PROXY DCS: FOR ANY CURRENT RU MEMBER (18 OR OLDER) WHO IS INSTITUTIONALIZED OR OTHERWISE INCAPACITATED.

SELF ................................... 1 {PC03A}
PROXY .................................. 2 {PC03OV1}

DISPLAY PID OF PERSON BEING ASKED ABOUT FOR ‘PID’. DISPLAY DATE OF BIRTH FOR PERSON BEING ASKED ABOUT FOR ‘MM/DD/YYYY’. DISPLAY THE RU ID FOR THE CURRENT CASE FOR ‘RUID-7’. DISPLAY ‘CURRENT’ IF PERSON BEING ASKED ABOUT IS A CURRENT RU MEMBER AND IS NOT DECEASED OR INSTITUTIONALIZED. DISPLAY ‘INSTITUTIONALIZED’ IF PERSON BEING ASKED ABOUT IS FLAGGED AS ‘INSTITUTIONALIZED’ FOR THE CURRENT ROUND.

FLAG ALL PERSONS WHO ARE ASKED PC03 FOR DCS FOLLOW-UP IN THE CLOSING (CL) SECTION.

DOB: {MM/DD/YYYY} PID: {PID} RU ID: {RUID-7}
STATUS: {CURRENT/INSTITUTIONALIZED}

INSTITUTIONALIZED ...................... 2 {PC03A}
OTHER .................................. 3 {PC03OV2}

THIS ITEM IS A SEPARATE SCREEN RATHER THAN AN OVERLAY AS IMPLIED BY THE ITEM NAME.

PREPARE {SELF/PROXY} DIABETES CARE SUPPLEMENT (DCS): WRITE IN PERSON NAME, PID, DATE OF BIRTH, AND RUID.

We hope that {you/{PERSON}}/you or someone else in the family} would be able to fill out this short questionnaire on the care {you/{PERSON}} {get/gets} for diabetes. {You/He/She} can give it to me before I leave today, or I can pick it up later.

DISPLAY ‘SELF’ AND ‘{you/{PERSON}}’ IF PC03 IS CODED '1' (SELF). DISPLAY ‘PROXY’ AND ‘you or someone else in the family’ IF PC03 IS CODED '2' (PROXY)

DISPLAY PID OF PERSON BEING ASKED ABOUT FOR ‘PID’. DISPLAY DATE OF BIRTH FOR PERSON BEING ASKED ABOUT FOR ‘MM/DD/YYYY’. DISPLAY THE RU ID FOR THE CURRENT CASE FOR ‘RUID-7’.

IF PANEL 16 ROUND 3 OR PANEL 15 ROUND 5, CONTINUE WITH BOX_05

OTHERWISE, GO TO BOX_07

NOTE: THE DISTRIBUTION AND COLLECTION OF THE CANCER SAQ OCCURS ONLY DURING PANEL 16 ROUND 3 AND PANEL 15 ROUND 5. AT THIS TIME, THERE ARE NO PLANS TO COLLECT THE CANCER SAQ IN FUTURE ROUNDS.

IF PERSON IS => 18 YEARS OF AGE OR IN AGE CATEGORIES 4-9 AND IF PERSON IS A KEY RU MEMBER AND ‘CANCER - {ANY TYPE}’ (CODED AT PE22 OR PE22OV) ON PERSON’S-MEDICAL-CONDITIONS-ROSTER AND FLAGGED AS CREATED IN THE PE SECTION (IN ANY ROUND), CONTINUE WITH BOX_06

OTHERWISE, GO TO BOX_07

IF PERSON BEING ASKED ABOUT IS FLAGGED AS ‘DECEASED’ OR ‘INSTITUTIONALIZED’ FOR THE CURRENT ROUND, GO TO BOX_07

OTHERWISE, CONTINUE WITH PC04

{During an earlier interview, it/It} was mentioned that (PERSON) {(have/has)/had} cancer. To obtain more information about experiences with cancer, we have a short questionnaire for (PERSON).

CONTINUE ............................... 1 {PC04A}
(PERSON) {DOES/DID}
NOT HAVE CANCER .............. 2 {BOX_07}

DISPLAY ‘During an earlier interview, it’ IF CANCER WAS NOT CREATED DURING THE CURRENT ROUND. DISPLAY ‘It’ IF CANCER WAS CREATED DURING THE CURRENT ROUND.

DISPLAY ‘(have/has)’ AND ‘DOES’ IF PE25 IS CODED ‘2’ (NO) FOR THIS PERSON FOR AT LEAST ONE CANCER TYPE. OTHERWISE, DISPLAY ‘had’ AND ‘DID’.

DISPLAY ‘PERSON’ IN PURPLE IN THE ANSWER TEXT. DISPLAY ‘NOT’ IN BOLD IN THE ANSWER TEXT. IF ‘PERSON DOES NOT HAVE CANCER’ IS SELECTED, THIS DOES NOT RE-SET THE DATA FROM THE PE SECTION (PRND.CANCERML). THE RESPONSE TO PC04 WILL DETERMINE WHETHER PC04A IS ASKED AND WHETHER THERE IS CANCER SAQ FOLLOW-UP FOR THIS PERSON IN THE CL SECTION.

NOTE: THE DISTRIBUTION AND COLLECTION OF THE CANCER SAQ OCCURS ONLY DURING PANEL 16 ROUND 3 AND PANEL 15 ROUND 5. AT THIS TIME, THERE ARE NO PLANS TO COLLECT THE CANCER SAQ IN FUTURE ROUNDS.

PREPARE ‘YOUR EXPERIENCES WITH CANCER’ (CANCER SAQ): WRITE IN PERSON NAME, DATE OF BIRTH, PID, AND RUID.

We hope that (PERSON) would be able to fill out this short questionnaire on (PERSON)’s experiences with cancer. (PERSON) can give it to me before I leave today, or I can pick it up later.

DISPLAY DATE OF BIRTH FOR PERSON BEING ASKED ABOUT FOR ‘MM/DD/YYYY’. DISPLAY PID OF PERSON BEING ASKED ABOUT FOR ‘PID’. DISPLAY THE RU ID FOR THE CURRENT CASE FOR ‘RUID-7’.

FLAG ALL PERSONS WHO ARE ASKED PC04A FOR CANCER SAQ FOLLOW-UP IN THE CLOSING (CL) SECTION.

CONTINUE WITH BOX_07

NOTE: THE DISTRIBUTION AND COLLECTION OF THE CANCER SAQ OCCURS ONLY DURING PANEL 16 ROUND 3 AND PANEL 15 ROUND 5. AT THIS TIME, THERE ARE NO PLANS TO COLLECT THE CANCER SAQ IN FUTURE ROUNDS.

IF ‘ASTHMA’ ON PERSON’S-MEDICAL-CONDITIONS-ROSTER, AND FLAGGED AS CREATED IN THE PE SECTION (IN ANY ROUND), CONTINUE WITH PC04B

OTHERWISE, GO TO BOX_08

{During an earlier interview, it was mentioned that {you/{PERSON}} {have/has} asthma.}

Now I would like to ask you a few questions about {your/{PERSON}’s} asthma and the course of treatment {you/he/she} received.

DISPLAY ‘During an earlier interview....’ IF ASTHMA WAS NOT CREATED DURING THE CURRENT ROUND. IF ASTHMA WAS CREATED DURING THE CURRENT ROUND, USE A NULL DISPLAY.

DISPLAY ‘NOT’ IN BOLD IN THE ANSWER TEXT. IF ‘PERSON DOES NOT HAVE ASTHMA’ IS SELECTED, THIS DOES NOT RE-SET THE DATA AS RECORDED IN THE PE SECTION (PRND.PCASTHMA). THE RESPONSE TO PC04B WILL DETERMINE WHETHER SUBSEQUENT DETAILED ASTHMA QUESTIONS ARE ASKED IN THIS PC SECTION.

I am going to ask you about two different kinds of asthma medicine. One is for quick relief. The other does not give quick relief but protects your lungs and prevents symptoms over the long term.

During the past 3 months, {have/has} {you/{PERSON}} used the kind of prescription inhaler that you breathe in through your mouth that gives quick relief from asthma symptoms?

YES .................................... 1 {PC05B}
NO ..................................... 2 {PC06A}
REF ................................... -7 {PC06A}
DK .................................... -8 {PC06A}

During the past 3 months, did {you/{PERSON}} use more than three canisters of this type of inhaler?

YES .................................... 1 {PC06A}
NO ..................................... 2 {PC06A}
REF ................................... -7 {PC06A}
DK .................................... -8 {PC06A}

{Have/Has} {you/{PERSON}} ever taken the preventive kind of asthma medicine used every day to protect your lungs and keep you from having attacks? Include both oral medicine and inhalers. This is different from inhalers used for quick relief.

YES .................................... 1 {PC06B}
NO ..................................... 2 {PC08}
REF ................................... -7 {PC08}
DK .................................... -8 {PC08}

{Are/Is} {you/{PERSON}} now taking this medication (that protects the lungs) daily or almost daily?

YES .................................... 1 {PC08}
NO ..................................... 2 {PC08}
REF ................................... -7 {PC08}
DK .................................... -8 {PC08}

A peak flow meter measures how hard you can blow air out of your lungs. {Do/Does} {you/{PERSON}} currently have a peak flow meter at home?

YES .................................... 1 {PC08A}
NO ..................................... 2 {BOX_08}
REF ................................... -7 {BOX_08}
DK .................................... -8 {BOX_08}

YES .................................... 1 {PC08B}
NO ..................................... 2 {BOX_08}
REF ................................... -7 {BOX_08}
DK .................................... -8 {BOX_08}

When did {you/{PERSON}} last use the peak flow meter? Was it within the last seven days, more than seven days ago but within the last thirty days, or more than thirty days ago?

WITHIN LAST 7 DAYS ..................... 1 {BOX_08}
MORE THAN 7, BUT WITHIN LAST 30 DAYS ... 2 {BOX_08}
MORE THAN 30 DAYS AGO .................. 3 {BOX_08}
REF ................................... -7 {BOX_08}
DK .................................... -8 {BOX_08}

Quality (Priority Conditions) Supplement (PC) Section