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Survey Questionnaires
Household (HC) Questionnaire Sections
Each MEPS-HC interview consists of sections covering specific topics.
Each section contains a series of CAPI (computer-assisted personal interview)
computer screens with questions, interviewing instructions, and skip
patterns based on the specific topics. Major changes to sections are
made by calendar year, and data released on full-year files are based
on the questions being asked during that year (regardless of panel).
Select questionnaire section and year:
For more information on the Household Component questionnaire sections, go to Summary of HC Questionnaire Sections and MEPS-HC Panel Design and Data Collection Process.
The F1 Help Text Key is the collection of terms used during the course of the MEPS-HC CAPI. These terms and their definitions are accessible to the interviewer via the F1 function key.
To access terms used in Rounds 1, 3 and 5, go to the F1 Help Text Key Rounds 1/3/5 (PDF,
461 KB) or HTML.
To access terms used in Rounds 2 and 4, go to the F1 Help Text Key Rounds 2/4 (PDF,
373 KB) or HTML.
MEPS-HC is a panel survey conducted over five rounds of data collection periods. Not all of the questionnaire sections are included in each round; some are periodically rotated in and out
of the survey.
For
each interview, the questionnaire flow varies slightly. Go to Questionnaire context/flow for
the context/flow detailed specifications
for each panel, information
on the specific order in which sections were asked during each interview,
and for an example of how to reconstruct the structure of an
interview for a particular panel and round.
HC Supplemental Paper Questionnaires
MEPS periodically administers paper
questionnaires to supplement the data collected by interviewers. These
questionnaires are available in both English and Spanish and include the
following:
A Survey about Understanding Veterans' Health Care Needs: Veterans Self-Administered Survey (VSAQ). VSAQ is a self-administered paper-and-pencil questionnaire fielded in 2018. VSAQ asks questions about highly prevalent medical conditions among Veterans such as PTSD and COPD. Sampled Veterans are asked about medical services used by Veterans such as: prosthesis, rehabilitation services, individual and group mental health care, caregiver support and assistive mobility devices. Questions are also asked about Veterans' perception of care received in and outside the VA including care received from primary doctors as well as specialists.
The Adult Self-Administered Questionnaire (SAQ) collects a variety of health status and health care quality measures of adults age 18 and older. The SAQ contains three measures of health status: the Veteran’s RAND 12-item (VR-12) (in 2017 this replaces the Short-Form 12 Version 2 (SF-12v2®), the Kessler Index (K6) of non-specific psychological distress, and the Patient Health Questionnaire (PHQ-2). The health care quality measures in the SAQ were taken from the health plan version of CAHPS®, an AHRQ-sponsored family of survey instruments designed to measure quality of care from the consumer's perspective.
The 2000 Parent Administered Questionnaire (PAQ). The PAQ
is a self-administered and mail-back questionnaire administered to
parents of children under 18 years of age. The PAQ was fielded only
in 2000, during Round 4 of Panel 4 and Round 2 of Panel 5 and included
questions from the Consumer Assessment of Health Plans (CAHPS®)
and the Living with Illness Measure (LWIM). In 2001, the content of
this PAQ was added as the Child Preventive Health section of the CAPI
instrument.
A Survey About Your Diabetes Care: The Diabetes Care Survey
(DCS). The DCS is a self-administered paper-and-pencil
questionnaire first fielded in 2000. Households receive
a DCS based on their response to a question in the Priority
Condition
section of the CAPI instrument, which asks whether or
not the respondent was ever told by a doctor or health professional
that he/she had diabetes.
The Cancer Self-Administered Questionnaire (CSAQ) was fielded in 2011, 2016 and 2017. AHRQ in collaboration with the National Cancer Institute fielded a self-administered questionnaire for current cancer patients and cancer survivors identified in the Medical Expenditure Panel Survey. The Cancer SAQ asked adult respondents questions about the burden of cancer, medical care for cancer, long lasting effects of the disease, financial impact, and employment outcomes for cancer survivors and their families.
The 2014 Preventive Care Self-Administered Questionnaire.
This SAQ is a paper-and-pencil questionnaire fielded during Panel 18 Round 5 of the 2014 Medical Expenditure Panel Survey (MEPS).
The survey was designed to collect a variety of person-level preventive health care data for adults. A subset of adults age 35 and older
as of the Round 5 interview date in MEPS households were asked to complete the PSAQ. The questionnaires were administered in early 2015.
Select questionnaire and year:
HC Interview Showcards
During the household interview, the
showcards assist MEPS respondents by providing them with paper versions
of definitions or response categories that pertain to specific questionnaire
items throughout the computer-assisted personal interview, or CAPI.
Select interview showcards by year:
Medical
Provider Component (MPC) Questionnaires
MEPS
also includes a Medical Provider Component (MPC) that requests data from hospitals,
physicians, home health care providers, and pharmacies identified
by MEPS-HC respondents. Its purpose is to supplement
and/or replace information received from the MEPS-HC respondents about
the health care that was provided to sampled household members in the course
of the survey year. The MPC Questionnaires are
designed to obtain information on both the medical and financial characteristics
of medical events. Beginning in 2009, the paper-based system for collecting data was replaced with a computer-based Integrated Data Collection System (IDCS) that allows
for data collection specialists to gather data through either telephone or through hardcopy record abstraction directly into one central database. The most current data years of the MPC questionnaires are available below.
MPC Questionnaires from previous data years are available upon request to the MEPS project director at mepspd@ahrq.gov.
Select MPC questionnaire and year:
MPC Contact Guides
The MPC Contact
Guides for hospitals, physicians, home health care providers, and pharmacies
each contain a script that guides the data collection specialist through
an explanation of the MEPS MPC, its purpose, and the data we would
like to collect. The guide also obtains contact information for data
collection itself after patient authorization forms have been sent
to the provider.
The most current data year of the contact guides are available below.
Contact guides from previous data years are available upon request
to the MEPS project director at mepspd@ahrq.gov.
Select contact guides used for medical
provider data collection and year:
MPC Authorization Forms
The MPC Authorization
Forms, signed by patients interviewed by MEPS, permit the Medical
Provider Component staff to contact medical providers and pharmacies
and authorize
providers to release medical information about their patients. The most
current data years of the authorization forms are available below. Please note that the Spanish authorization forms are for Spanish-speaking respondents to read; they sign the English forms.
MPC Authorization
Forms from previous data years are available upon request to the MEPS
project director at mepspd@ahrq.gov.
Select authorization forms used for medical
provider data collection and year:
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