Cms-p-0015a Mcbs

Medicare Current Beneficiary Survey (MCBS)

MBQ

Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)

OMB: 0938-0568

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Mobility of Beneficiaries (MBQ)
Variable Name
MR Screen Name
BOX MBBEG
MTBLGTPL
MB1

Question type
routing
yes/no

Question text/description
GO TO MB1 - MTBLGTPL.
My next questions are about [your/(SP)’s] travel activities and [your/his/her] health.
Because of a health or physical problem, [have you/has (SP)]...

MREDTRAV

MB2

yes/no

had trouble getting places, like the doctor’s office, a supermarket, or a friend’s house since (REFERENCE
DATE)]?
Because of a health or physical problem, [have you/has (SP)]…
reduced [your/his/her] day-to-day travel since (REFERENCE DATE)]?

MASKRIDE

MB3

yes/no

Because of a health or physical problem, [have you/has (SP)]...
asked others for rides since (REFERENCE DATE)]?

BOX MB1

routing

MGIVUPDR

MB5

yes/no

MLIMDRIV

MB4

yes/no

MUSETRNS

MB6

yes/no

routing

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

If the respondent ever reported that they don't drive, have never driven, or gave up driving
(SAMPLE_PERSON.P_MGIVUPDR = 3, 4, or 5), go to MB6-MUSETRNS.
Else go to MB5-MGIVUPDR.
Because of a health or physical problem, [have you/has (SP)]...

(01) YES
(02) NO
given up driving altogether since (REFERENCE DATE)]?
(03) DOESN'T DRIVE (DO NOT DISPLAY.)
(04) HAS NEVER DRIVEN
[PROBE FOR PROPER RESPONSE IF R OFFERS MORE THAN A YES OR NO RESPONSE, USING PROBES SUCH AS
(05) GAVE UP DRIVING BEFORE (REFERENCE DATE)
“Was this because of a health or physical problem” and “I just want to check whether this was before or after (-8) Don't Know
(REFERENCE DATE)”.]
(-9) Refused
Because of a health or physical problem, [have you/has (SP)]…
(01) YES
(02) NO
limited driving to daytime since (REFERENCE DATE)]?
(03) DOES NOT DRIVE (DO NOT DISPLAY.)
(-8) Don't Know
[PROBE FOR PROPER RESPONSE IF R OFFERS MORE THAN A YES OR NO RESPONSE, USING PROBES SUCH AS
(-9) Refused
“Was this because of a health or physical problem” and “I just want to check whether this was before or after
(REFERENCE DATE)”.]
[IF THE R DOES NOT DRIVE, BACK UP AND CHANGE THE RESPONSE TO THE PREVIOUS QUESTION.]
Because of a health or physical problem, [have you/has (SP)]...
used a taxi or special transportation service since (REFERENCE DATE)]?

BOX MBEND

Code list

[EXPLAIN IF NECESSARY: A special transportation service may include a van or shuttle service for seniors or
people with disabilities.]
GO TO NEXT SECTION (HFQ)

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused


File Typeapplication/pdf
AuthorNORC
File Modified2016-03-17
File Created2016-03-17

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