Understanding Veterans' Health Care Needs Data Year 2019

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Form Approved
OMB# 0935-0118
Exp. Date: 11/30/2021

Medical Expenditure Panel Survey (MEPS)

Understanding Veterans’ Health Care Needs

This survey is about understanding the health care needs and utilization of military veterans. Please take a few minutes to answer the questions in this booklet.

Survey Instructions

Please answer each question by marking the answer boxes as indicated . If you are unsure about how to answer a question, please give the best answer you can.

You are sometimes told to skip over some question in this form. When this happens, you will see arrows that tell you what question to go to next, like this:

Yes

No GO TO Question 4

Next Question

Your participation is voluntary and all of your answers will be kept confidential to the extent permitted by law. If you have any question about this booklet, please call Alex Scott at 1-800-945-6377.
When you have completed the survey, place it in the envelope provided and give it to your interviewer.

This Booklet Should
Be Completed By

Region:

RUID:

PID:

Name:

DOB:

This survey is authorized under 42 U.S.C. 299a. The confidentiality of your responses to this survey is protected by Sections 944(c) and 308(d) of the Public Health Service Act [42 U.S.C. 299c-3(c) and 42 U.S.C. 242m(d)]. Information that could identify you will not be disclosed unless you have consented to that disclosure. Public reporting burden for this collection of information is estimated to average 7 minutes per response, the estimated time required to complete the survey. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-0118) AHRQ, 5600 Fishers Lane, Room #07W42, Rockville, MD 20857.

Department of Health and Human Services (DHHS)

The Agency for Healthcare Research and Quality and
The Centers for Disease Control and Prevention of the
U.S. Department of Health and Human Services

Military History

This first section asks about your military history.

Have you ever served on active duty in the U.S. Armed Forces, Reserves, or National Guard?

No, never served in the military [Please go to the “Date completed” boxes on the back cover.]

Yes, but only on active duty for training in the Reserves or National Guard [Please go to the “Date completed” boxes on the back cover.]

Yes, and I am still on active duty [Please go to the “Date completed” boxes on the back cover.]

Yes, I was on active duty in the past, but not now

When did you serve on active duty in the U.S. Armed Forces?

Please mark yes for each period in which you served, even if it was just for part of the period. Mark no if you did not serve any part of the period listed.

Yes

September 2001 or later.

a1.

IF YES to a, did you serve in a combat theater of operations during this time?

August 1990 to August 2001, including the Persian Gulf War

b1.

IF YES to b, did you serve in a combat theater of operations after November 11, 1998?

b2.

IF YES to b, did you serve in southwest Asia between August 2, 1990 and November 11, 1998?

June 1975 to July 1990

February 1961 to May 1975 (Vietnam era)

February 1955 to January 1961

July 1950 to January 1955 (Korean War)

January 1947 to June 1950

December 1941 to December 1946 (World War II)

November 1941 or earlier

Do you have a VA service-connected disability rating?

Yes

No GO TO Question 5

What is your VA service-connected disability rating?

0 percent

10 or 20 percent

30 or 40 percent

50 or 60 percent

70 percent or higher

Were you discharged or retired from the military for a disability incurred in the line of duty?

Yes

Are you a Purple Heart award recipient?

Yes

Are you a former prisoner of war (POW)?

Yes

What type of discharge did you receive when you were released from military service?

Honorable Discharge

General Discharge under Honorable Conditions

Other than Honorable (OTH) Discharge

Bad Conduct Discharge

Dishonorable Discharge

Administrative/entry-level separation

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Your Health and Health Care Services

This section is about your health conditions that you may have now or had in the past.

Has a doctor or other health provider ever told you that you have any of the following?

Mark Yes or No for each row.

General Conditions

Yes

COPD (Chronic Obstructive Pulmonary Disease)

Dermatological conditions

GERD (Gastroesophageal reflux disease)

Hearing loss

Musculoskeletal Conditions

Yes

Back pain

Joint pain

Osteoarthritis

Gout

Neck pain

Fibromyalgia

TMD (Temporomandibular Joint Dysfunction)

Lupus

Mental Health Conditions

Yes

PTSD (Post-traumatic Stress Disorder)

Alcohol abuse

Drug abuse

Schizophrenia

Bipolar disorder

Depression

Other mood disorder

10.

Since discharge from military service, have you received any of the following services?

If yes for any service, indicate whether received from the VA and/or outside of the VA, otherwise select no if you did not receive the listed services.

Yes, from the VA

Yes, outside the VA

Prosthesis

Rehabilitation services

Individual mental health care

Group counseling for mental health care

Prescription medications

Caregiver support

Assistive mobility device (e.g., wheelchairs, scooters, walkers, canes)

11.

A primary care provider is the health provider you see most often and who knows you best. How much of a factor are each of the following to you in choosing a primary care provider?

Mark one response for each row.

Major factor

Minor factor

Not a factor

Don't know

The cost of care

The recommendation of another doctor

The reputation of the personal doctor providing the care

Short wait time for appointments

Location of the doctor’s practice

The doctor is in my health plan’s provider network

The doctor understands the special needs of veterans

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Health Care from Outside the VA

This section is about health care you received from outside of the VA. This includes any visit to a doctor, hospital, or clinic for health care that was not at a VA facility.
Do not include dental care.

12.

Did you visit any health care provider outside of the VA in the last 12 months?

Yes

No GO TO Question 19

For these next questions, please only think about the non-VA health care provider you saw most often in the last 12 months.

13.

In the last 12 months, when you needed care right away, how often did you get care as soon as you thought you needed?

Never

Sometimes

Usually

Always

14.

In the last 12 months, how often did your non-VA provider’s office keep health information about you complete and up-to-date?

Never

Sometimes

Usually

Always

15.

In the last 12 months, did you ask someone in your non-VA provider’s office for your medical records?

Yes

No GO TO Question 17

16.

In the last 12 months, when you asked someone at your non-VA provider’s office for your medical records, how often did you get them as soon as you needed?

Never

Sometimes

Usually

Always

17.

Is your non-VA provider aware of the new health care services you received at the VA in the last 12 months?

I did not receive any health care services at the VA In the last 12 months [Please go to the “Date completed” boxes on the back cover.]

Yes GO TO Question 19

18.

Sometimes, health care providers need to be aware of services you receive from others to coordinate your care. How much of a problem was it that your non-VA provider was not aware of the services you received at the VA?

Not a problem

A small problem

A big problem

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Health Care at the VA

This section is about health care services you received at a VA facility. This includes visits to a VA doctor, hospital, or clinic for health care.

19.

In the last 12 months, have you received any care from a VA provider? This includes any health care you received at a VA facility. Do not include dental visits.

Yes

No [Please go to the “Date completed” boxes on the back cover.]

20.

Do you have a primary care provider or Patient Aligned Care Team (PACT) at the VA who you have visited in the last 12 months?

A patient Aligned Care Team, or PACT, includes your primary care provider, nurse care manager, clinical associate, and administrative clerk.

Yes

No GO TO Question 31

These next questions are about your experience with your VA primary care provider/PACT.

21.

In the last 12 months, how often did your VA primary care provider/PACT know about your past health problems or past treatments?

Never

Sometimes

Usually

Always

22.

In the last 12 months, did you see a VA health care provider other than your VA primary care provider/PACT?

Yes

No GO TO Question 24

23.

In the last 12 months, how often did your VA primary care provider/PACT know about any tests or results from visits to other VA health care providers?

Never

Sometimes

Usually

Always

24.

In the last 12 months, how often did your VA primary care provider/PACT keep health information about you complete and up-to-date?

Never

Sometimes

Usually

Always

25.

In the last 12 months, did you ask your VA primary care provider/PACT for your medical records?

Yes

No GO TO Question 27

26.

In the last 12 months, when you asked your VA primary care provider/PACT for your medical records, how often did you get them as soon as you needed?

Never

Sometimes

Usually

Always

27.

In the last 12 months, did you need a referral from your VA primary care provider/PACT to see a non-VA health provider?

Yes

No GO TO Question 29

28.

In the last 12 months, when you needed a referral from your VA primary care provider/PACT to see a non-VA health care provider, how often did you get a referral as soon as you needed it?

Never

Sometimes

Usually

Always

29.

Is your VA primary care provider/PACT aware of the health care services you received outside the VA in the last 12 months?

I did not receive any health care services outside the VA In the last 12 months GO TO Question 31

Yes GO TO Question 31

30.

Sometimes, health care providers need to be aware of services you receive from others to coordinate your care. How much of a problem was it that your VA primary care provider/PACT was not aware of services you received outside the VA?

Not a problem

A small problem

A big problem

Return to Start

Health Care from Specialists

This section is about health care services you received from a specialist.

Specialists are doctors like surgeons, heart doctors, psychiatrists, allergy doctors, skin doctors, and other doctors who specialize in one area of health care.

31.

In the last 12 months, did you receive care from any VA specialist other than your VA primary care provider/PACT?

Yes

No [Please go to the “Date completed” boxes on the back cover.]

The following questions ask about care you received from the VA specialist you saw most often in the last 12 months other than your VA primary care provider/PACT.

32.

When you saw this VA health care specialist, did he or she have enough information about your medical history?

Yes

33.

Was this VA specialist aware of the health care services you received outside the VA in the last 12 months?

I did not receive any health care services at the VA In the last 12 months [Please go to the “Date completed„ boxes on the back cover.]

Yes [Please go to the “Date completed„ boxes on the back cover.]

34.

Sometimes, health care providers need to be aware of treatments you receive from others to coordinate your care. How much of a problem was it that your VA specialist was not aware of services you received outside the VA?

Not a problem

A small problem

A big problem

Date completed:

Who completed this form?

Person named on front of this form

Someone else,

If Someone Else, what is person’s relationship to the person named on the front of this form?

Husband or wife

Unmarried partner

Mother, father, or guardian

Son or daughter

Other relative

Not related

THANK YOU FOR COMPLETING THE QUESTIONNAIRE!

Please place this survey in the envelope provided to you and give it to the MEPS interviewer.

If the interviewer is no longer available, place the survey in the return envelope provided to you by the interviewer. If the envelope is missing, mail this survey to:

MEPS
c/o Westat
1600 Research Blvd, Room GA51
Rockville, MD 20850

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