BOX_01
IF ROUND 1 OR IF RESPONDENT FOR THIS ROUND IS NOT
THE SAME AS THE RESPONDENT FOR THE PREVIOUS ROUND,
GO TO CA01
IF NOT ROUND 1 AND IF RESPONDENT FOR THIS ROUND
IS SAME AS RESPONDENT FOR THE PREVIOUS ROUND,
CONTINUE WITH BOX_02
BOX_02
IF NOT ROUND 1 AND RESPONDENT USED ANY CALENDAR
DURING THE PREVIOUS ROUND’S INTERVIEW - CL67 IS
CODED ‘1’ (YES) FOR USE OF MONTHLY PLANNER, HEALTH
EVENTS WORKSHEET, RECORD FILE, OR OTHER CALENDAR,
GO TO CA02
OTHERWISE, CONTINUE WITH CA01
CA01
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.
TYPES OF RECORDS THAT ARE HELPFUL (USE RECORDS JOB AID
IN QUICK
REFERENCE GUIDE AS NEEDED):
- Any kind of calendar or electronic calendar that you
regularly use to
keep track of health care appointments. (If you wrote
things down on
the monthly planner we mailed you, we can use that.)
- Any records that might help you remember health care
received without
an appointment, such as a health insurance statement,
or a payment
record like a credit card statement or checkbook log.
ASK RESPONDENT TO GET RECORD KEEPING MATERIALS IF NOT
ALREADY OUT.
HAS MEPS RECORD KEEPING MATERIALS ..... 1 {CA03}
HAS SOME OTHER TYPE OF RECORD KEEPING
MATERIALS ............................. 2 {CA03}
DOES NOT HAVE RECORDS ................. 3 {CA04}
WILL NOT USE RECORDS .................. 4 {CA04}
[Code One]
DISPLAY ‘since {START DATE OF REFERENCE PERIOD}’
IF NOT ROUND 5. DISPLAY ‘between {START DATE OF
REFERENCE PERIOD} and {END DATE OF REFERENCE
PERIOD}’ IF ROUND 5.
FOR ‘START DATE OF REFERENCE PERIOD’, DISPLAY THE
START DATE OF THE CURRENT INTERVIEW AS MM/DD/YYYY.
FOR ‘END DATE OF REFERENCE PERIOD’, DISPLAY THE RU
END DATE FOR ROUND 5 AS MM/DD/YYYY.
CA02
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.
TYPES OF RECORDS THAT ARE HELPFUL (USE RECORDS JOB AID
IN QUICK
REFERENCE GUIDE AS NEEDED):
- Any kind of calendar or electronic calendar that you
regularly use to
keep track of health care appointments. (If you wrote
things down on
the monthly planner we mailed you, we can use that.)
- Any records that might help you remember health care
received without
an appointment, such as a health insurance statement,
or a payment
record like a credit card statement or checkbook log.
THANK RESPONDENT FOR USING RECORDS DURING THE PREVIOUS
INTERVIEW.
ASK RESPONDENT TO GET RECORD KEEPING MATERIALS IF NOT
ALREADY OUT.
HAS MEPS RECORD KEEPING MATERIALS...... 1 {CA03}
HAS SOME OTHER TYPE OF RECORD KEEPING
MATERIALS ............................. 2 {CA03}
DOES NOT HAVE RECORDS ................. 3 {CA04}
WILL NOT USE RECORDS .................. 4 {CA04}
[Code One]
DISPLAY ‘since {START DATE OF REFERENCE PERIOD}’
IF NOT ROUND 5. DISPLAY ‘between {START DATE OF
REFERENCE PERIOD} and {END DATE OF REFERENCE
PERIOD}’ IF ROUND 5.
FOR ‘START DATE OF REFERENCE PERIOD’, DISPLAY THE
START DATE OF THE CURRENT INTERVIEW AS MM/DD/YYYY.
FOR ‘END DATE OF REFERENCE PERIOD’, DISPLAY THE RU
END DATE FOR ROUND 5 AS MM/DD/YYYY.
CA03
Has anyone in the family been keeping records of
all visits to medical
providers and medical places, most of the
visits, only some of the
visits, or have no records been kept?
IF MORE THAN ONE PERSON IN RU: Do you have records
that cover health
care received for each person (in your
family)?
PROBE AS NEEDED TO ESTABLISH HOW WELL THE
RESPONDENT’S RECORDS COVER THE
HEALTH CARE VISITS FOR ALL FAMILY MEMBERS.
ALL VISITS RECORDED .................... 1 {BOX_05}
MOST VISITS RECORDED ................... 2 {BOX_05}
SOME VISITS RECORDED ................... 3 {CA04}
NO RECORDS KEPT......................... 4 {CA04}
VOLUNTEERED: NO EVENTS TO RECORD ...... 5 {BOX_05}
REF ................................... -7 {CA04}
DK .................................... -8 {CA04}
[Code One]
THE COMPUTER SUMMARY ITEMS (BOX_03 – CA05) WERE
REMOVED IN PANEL 12 ROUND 2. STARTING IN
PANEL 13, THESE ITEMS WILL BE OMITTED IN ALL
ROUNDS.
CA04
GIVE RESPONDENT A MONTHLY PLANNER (CALENDAR).
Through the rest of the interview, there are questions
that will ask for
dates. When you do not remember the date, we can refer
to this calendar
for help.
CIRCLE {TODAY'S DATE/12/31/{YEAR}} {AND DATE OF LAST
INTERVIEW}.
PRESS ENTER OR SELECT NEXT PAGE TO CONTINUE.
DISPLAY ‘TODAY’S DATE’ IF NOT ROUND 5. DISPLAY
‘12/31/{YEAR}’ IF ROUND 5. FOR {YEAR} DISPLAY
SECOND YEAR OF PANEL.
Display ‘AND DATE OF LAST INTERVIEW’ if not
ROUND 1. OTHERWISE, USE A NULL DISPLAY.
THE COMPUTER SUMMARY ITEMS (BOX_03 – CA05) WERE
REMOVED IN PANEL 12 ROUND 2. STARTING IN
PANEL 13, THESE ITEMS WILL BE OMITTED IN ALL
ROUNDS.
GO TO BOX_05
BOX_03
OMITTED.
BOX_04
OMITTED.
CA05
OMITTED.
BOX_05
GO TO NEXT QUESTIONNAIRE SECTION
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