CFI 177 DOD Tricare Outpatient questionnaire

Aug. 2008

TRICARE

OUTPATIENT CUSTOMER SATISFACTION SURVEY

Final Version

Introduction

PROG. NOTE: Move in CONTACT NAME from sample

[CONTACT NAME]: FNAME LNAME FROM SAMPLE

________________________________________________________________________

May I speak with (RESTORE CONTACT NAME)?

Hello, I'm (NAME) calling on behalf of the Military Health System (TRICARE). The Department of Defense is conducting a world-wide survey of DoD health care beneficiaries aimed at understanding and improving your health care. We are asking your opinions about the health care experiences you’ve had in major facilities within the last 12 months. Your participation will help improve the health care offered to DoD Beneficiaries throughout the world.

Today I want to ask you about services you may have received from the Military Health Facility. This survey helps health policy makers gauge beneficiary satisfaction with the current military health care system and provides valuable input from beneficiaries that will be used to improve the Military Health System. Your opinions are very important for this research. Your name will be held completely confidential and never connected to your answers. Your participation is voluntary and you may stop at any time or skip any question you do not wish to answer. This interview will take 8-10 minutes and is authorized by Office of Management and Budget Control No. 1505-0191.

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PROG. NOTE: TERMINATE SCREEN

Those are all of the questions I have for you. Thank you for your interest in this project.

Previous Expectations

Now, I am going to ask you some questions about the Military Health Facility with which you have had experience as an outpatient.

Q1. Before you entered the Military Health Facility for outpatient care, you probably knew something about that Facility. Now think back and remember your expectations of the overall quality of the Military Health Facility. Please give me a rating on a 10-point scale on which "1" means your expectations were "not very high" and "10" means your expectations were "very high."

How would you rate your expectations of the overall quality of the Military Health Facility?

[RECORD NUMBER 1-10]

DK

REF

Access to care/Appointment Setting

Now, let's think about who gives you your medical care at the Military Health Facility that you recently visited…

Q2. Do you have an assigned provider or a team in charge of your medical care at that Military Health Facility?

1. Yes, one medical care provider or team

2. No

DK

REF

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Now, let’s talk about the kind of service you get at the Military Health Facility that you recently visited…

Q3. How accessible and easy to use is that Military Health Facility for you? Use a 10-point scale again on which “1” means “very inaccessible and difficult to use” and “10” means “very accessible and easy to use.” How inaccessible or accessible is that Military Health Facility?

[RECORD NUMBER 1-10]

DK

REF

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Q4. What is the primary means you used to make an appointment or to obtain services at the Military Health Facility where you were recently an outpatient? (READ CODES 1-6 IF NECESSARY; ACCEPT ONE MENTION)

1. E-mail

2. Referral from other facility

3. Internet/World Wide Web

4. Telephone call

5. Visit to medical center

6. Written communication

7. Some other means

8. Not applicable/do not obtain services from this center

DK

REF

Q5. How courteous are the appointment personnel? On a 10-point scale on which “1” means “not at all courteous” and “10” means “very courteous,” how courteous are the appointment personnel?

[RECORD NUMBER 1-10]

DK

REF

Information/Results

Now, let's think about the information you received from caregivers at the Military Health Facility…

Q6. If you had concerns you needed answered, how clearly did your caregiver provide information to you in a way you could understand? Using a 10-point scale again on which “1” means “not at all clearly” and “10” means “very clearly,” how clearly did the Military Health Facility caregivers provide information to you in a way you could understand?

[RECORD NUMBER 1-10]

DK

REF

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Q7. How clearly did doctors or nurses explain test results to you in a way you could understand? Using a 10-point scale again on which “1” means “not at all clearly” and “10” means “very clearly,” how clearly did the Military Health Facility doctors or nurses explain test results to you in a way you could understand?

[RECORD NUMBER 1-10]

DK

REF

Comfort/Service

Now let’s talk about your physical comfort during your outpatient experience at the Military Health Facility…

Q8. To what degree did you feel you were treated with respect and dignity while in the facility/hospital? On a 10-point scale on which “1” means “not at all treated with dignity and respect” and “10” means “very much treated with dignity and respect,” to what degree did you feel you were treated with respect and dignity while in the facility/hospital?

[RECORD NUMBER 1-10]

DK

REF

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Q9. How courteous were your doctors? On a 10-point scale on which “1” means “not at all courteous” and “10” means “very courteous,” how courteous were your doctors?

[RECORD NUMBER 1-10]

DK

REF

________________________________________________________________________

Q10. And how courteous were your nurses? On a 10-point scale on which “1” means “not at all courteous” and “10” means “very courteous,” how courteous were your nurses?

[RECORD NUMBER 1-10]

DK

REF

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Q11. Please consider all your experiences in the past 12 months with outpatient care at the Military Health Facility. Using a 10-point scale, on which "1" means "not very high" and "10" means "very high," how would you rate the overall quality of outpatient care at the Military Health Facility?

[RECORD NUMBER 1-10]

DK

REF

Satisfaction - ACSI

Satisfaction includes many things. Let's move on and talk about your overall satisfaction with the outpatient care at the Military Health Facility.

Q12. First, please consider all your experiences to date as an outpatient at the Military Health Facility. Using a 10-point scale on which “1” means “very dissatisfied” and “10” means “very satisfied,” how satisfied are you with that Military Health Facility?

[RECORD NUMBER 1-10]

DK

REF

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Q13. Considering all of your expectations, to what extent has the outpatient care at the Military Health Facility fallen short of or exceeded your expectations? Using a 10-point scale on which "1" now means "falls short of your expectations" and "10" means "exceeds your expectations," to what extent has that Military Health Facility fallen short of or exceeded your expectations?

[RECORD NUMBER 1-10]

DK

REF

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Q14. Forget the Military Health Facility for a moment. Now, I want you to imagine an ideal medical center providing outpatient care. (PAUSE) How well do you think the Military Health Facility compares with that ideal medical center? Please use a 10-point scale on which "1" means "not very close to the ideal," and "10" means "very close to the ideal."

[RECORD NUMBER 1-10]

DK

REF

Complaints

Next, I want you to think about any communication you may have had with the Military Health Facility regarding complaints about your outpatient care experience.

Q15. Have you complained to the Military Health Facility within the past year?

1 Yes

2. No

DK

REF

________________________________________________________________________

{IF Q15 = 1, ASK OTHERWISE GO TO Q17}

Q16. How well, or poorly, was your most recent complaint handled? Using a 10-point scale on which “1” means “handled very poorly” and “10” means “handled very well,” how would you rate the handling of your complaint?

[RECORD NUMBER 1-10]

DK

REF

________________________________________________________________________

Q17. How difficult or easy was it to make your most recent complaint? Using a 10-point scale on which “1” means “very difficult” and “10” means “very easy,” how difficult or easy was it to make a complaint?

[RECORD NUMBER 1-10]

DK

REF

Q18. What method did you use to make your most recent complaint?

Outcomes

Q19. How likely is it that you will use the Military Health Facility again in the future when you need outpatient medical care? On a 10-point scale on which “1” means “very unlikely” and “10” means “very likely,” how likely is it that you will use the Military Health Facility again?

[RECORD NUMBER 1-10]

DK

REF

________________________________________________________________________

Q20. If asked, how willing would you be to say positive things about outpatient care at the Military Health Facility to other military beneficiaries? On a 10-point scale on which “1” means “not at all willing” and “10” means “very willing,” how willing would you be to say positive things about that Military Health Facility?

[RECORD NUMBER 1-10]

DK

REF

________________________________________________________________________

Demographics

Now, we need to ask a few demographic questions for research purposes only…

QD1. What is your age, please?

[RECORD NUMBER OF YEARS 1-120]

DK

REF

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QD2. What is the highest level of formal education you completed? (READ CODES 1-5)

1. Less than high school

2. High school graduate

3. Some college or associate degree

4. College graduate

5. Post-Graduate

DK

REF

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QD3. Are you of Hispanic, Latino or Spanish origin?

1. Yes

2. No

DK

REF

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QD4. Do you consider your race(s) as: (READ CODES 1-5, ACCEPT UP TO 5 MENTIONS)

1. White

2. Black or African American

3. American Indian or Alaska Native

4. Asian

5. Native Hawaiian or other Pacific Islander

6. Other race

DK

REF

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QD5. What was your total annual family income in 2007? (READ CODES 1-7 AS NECESSARY) (READ IF NECESSARY: Before taxes)

1. Under $20,000

2. $20,000 but less than $30,000

3. $30,000 but less than $40,000

4. $40,000 but less than $60,000

5. $60,000 but less than $80,000

6. $80,000 but less than $100,000

7. $100,000 or more

DK

REF

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QD6. Gender (By Observation)

1. Male

2. Female

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PROG. NOTE: APPEND ALL SAMPLE VARIABLES.