Attachment B R79 MPQ revisions (Feb 2017 non-sub change request)

Medical Provider Utilization (MPQ)
Variable Name
MR Screen Name

Question text/description

Code list

MPQ SPECIFICATIONS
CRITERIA
INTTYPE=C001, C002, C004, C005, C006, C007, C009, C010
SPALIVE=ALL
SEASON=ALL
SPPROXY=SP or PROXY
Other: N/A
PLACEMENT
Administer after HHQ.

MPPRMDOC

MP1

(Besides what you have already mentioned), [(Since/since (REFERENCE DATE/UTILDATE)/(Between/between)
(REFERENCE DATE) and (DATE OF DEATH/DATE OF INSTITUTIONALIZATION/ENDUTILD), [have you/has
(SP)/did (SP)] [seen/see] any medical doctors?
(01) YES
INCLUDE ANY VISITS FOR TESTS/X-RAYS.
(02) NO
SEE SHOWCARD AC1 FOR TYPES OF MEDICAL DOCTORS, IF NECESSARY.
(-8) Don't Know
(-9) Refused
[DO NOT INCLUDE MEDICAL DOCTORS SEEN IN THE EMERGENCY ROOM, OUTPATIENT DEPARTMENT OR
CLINIC, AT THE RESPONDENT’S HOME, OR DURING AN INPATIENT STAY.]
(01) [Continuous answer.]

PROVIDER_MP

MP2

Who did [you/(SP)] see?
SELECT OR ADD ONLY ONE PROVIDER.

[PROVIDER LOOKUP CALLED FROM THIS SCREEN]
ENTER THE NAME OF THE PROVIDER AND THE BILLING/GROUP OR PRACTICE NAME BELOW.
PROVNAME

MP2

YOU MUST ENTER A PROVIDER NAME IN THE ‘NAME’ FIELD. IF THE PROVIDER IS AN INDIVIDUAL BUT YOU DO
NOT KNOW THE PROVIDER’S NAME, OR IF THE PROVIDER IS AN ORGANIZATION, ENTER THE GROUP OR
PRACTICE NAME IN THE ‘NAME’ FIELD AND LEAVE THE ‘GROUP’ FIELD BLANK.
NAME:

GROUPNAM

MP2

GROUP:

[DISPLAY PROVIDER ROSTER AS RESPONSE OPTIONS:
1. [PROVIDER 1]
2. [PROVIDER 2]
…
N. [PROVIDER N]
N+1. ADD ANOTHER
DISPLAY PROVIDER NAME, SPECIALITY, GROUP NAME
FOR ALL PROVIDERS WHERE PROVNUM>02.

BOX MP1B

PROVSPEC

MP2A

PROVSPOS

MP2A
BOX MP1

VAPLACE

IF (PROVIDER IS A MEDICAL PLACE) OR (PROVIDER SPECIALTY HAS ALREADY BEEN COLLECTED), GO TO BOX
MP1.
ELSE GO TO MP2A - PROVSPEC.

(01) DENTIST/DENTAL PROVIDER
(02) MEDICAL DOCTOR
(03) AUDIOLOGIST
(04) CHIROPRACTOR
(05) CLINICAL SOCIAL WORKER
(06) DIETITIAN-NUTRITIONIST
(07) HEARING THERAPIST
(08) HOME HEALTH/HEALTH AIDE
(09) HOMEMAKER
(10) HOSPICE WORKER
(11) I.V. THERAPIST
(12) NURSE (RN)
What kind of (health practitioner/mental health professional/therapist/medical person) is (PROVIDER NAME)?
(13) NURSE PRACTITIONER
(14) NURSE'S AIDE
[SELECT THE RESPONSE CATEGORY FOR A GIVEN SPECIALTY ONLY IF THE RESPONDENT SPECIFICALLY NAMES
(15) OCCUPATIONAL THERAPIST (OT)
THE LISTED SPECIALTY OR MENTIONS THE WORDS OR INITIALS IN PARENTHESES FOLLOWING THAT
(16) OPTOMETRIST (OD)
PROVIDER SPECIALTY. IF THE RESPONDENT NAMES A MEDICAL SPECIALTY NOT LISTED BELOW, BUT LISTED
(17) OSTEOPATH (DO)
ON SHOWCARD AC1, SUCH AS ‘CARDIOLOGY,’ SELECT 'MEDICAL DOCTOR.']
(18) PARAMEDIC
(19) PHYSICAL THERAPIST (PT)
(20) PHYSICIAN'S ASSISTANT
(21) PODIATRIST (FOOT DOCTOR)
(22) PSYCHOLOGIST
(23) RESPIRATORY THERAPIST
(24) SOCIAL/CASE WORKER
(25) SPEECH THERAPIST
(26) THERAPIST (MENTAL HEALTH)
(27) X-RAY TECHNICIAN
(28) LICENSED PRACTICAL NURSE (LPN)
(29) ACUPUNCTURIST
OTHER MEDICAL PROVIDER (SPECIFY)
(01) [Continuous answer.]
IF (SP REPORTED RECEIVING HEALTH CARE SERVICES THROUGH V.A. IN THE CURRENT ROUND OR ANY
PREVIOUS ROUND) AND (IF THIS PROVIDER IS ASSOCIATED WITH V.A. IS UNKNOWN), GO TO MP3 - VAPLACE.
ELSE GO TO BOX MP2.

MP3

Is (PROVIDER NAME) associated with a Department of Veterans Affairs, or V.A., facility?

BOX MP2

IF (SP COVERED BY A MANAGED CARE PLAN ANYTIME DURING THE CURRENT ROUND) AND (IF THIS
PROVIDER IS ASSOCIATED WITH A MANAGED CARE PLAN IS UNKNOWN), GO TO MP4 - HMOASSOC.
ELSE IF (SP COVERED BY A MANAGED CARE PLAN ANYTIME DURING THE CURRENT ROUND) AND (THIS
PROVIDER IS NOT ASSOCIATED WITH A MANAGED CARE PLAN), GO TO MP5 - HMOREFER.
ELSE GO TO MP6 - EVENT.

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

HMOASSOC

MP4

Is (PROVIDER NAME) associated with [your/(SP’s)] [READ MANAGED CARE PLAN NAME(S) BELOW] plan?

[Were you/Was (SP)] referred to (PROVIDER NAME) by [READ MANAGED CARE PLAN NAME(S) BELOW]?
HMOREFER

MP5
[INCLUDE REFERRALS BY THE RESPONDENT’S PRIMARY CARE PHYSICIAN (PCP).]
When did [you/(SP)] see (PROVIDER NAME)? Please tell me all the dates [since (REFERENCE
DATE/UTILDATE)/between (REFERENCE DATE) and (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION/ENDUTILD)].
ENTER ALL DATES.

EVENT

MP6
[IF THE RESPONDENT SAW THE SAME PROVIDER TWICE ON THE SAME DAY, ENTER THE DATE ONLY ONCE.]

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

(01) [Continuous answer.]
(

IF R HAD 5 OR MORE VISITS TO THIS PROVIDER DURING THIS REFERENCE PERIOD, SELECT "REPEAT VISITS"
AND LEAVE THE DAY FIELD BLANK. ENTER EACH MONTH SEPARATELY.
HAVE ALL DATES BEEN ENTERED?
MPADD

MP6
[DISPLAY ALL EVENTS ASSOCIATED WITH THIS PROVIDER]
YOU HAVE ENTERED DATES FOR THE FOLLOWING EVENTS. SELECT AN EVENT TO DISCUSS WITH SP OR PRESS
[PREVIOUS] TO GO BACK AND ADD MORE EVENTS.

NAVIGATOR

MP6_IN

BOX MP2AA

MPSDVIS

MP6B
BOX MP2B
BOX MP2C

ANYOPERS

MP7

SPECCOND

MP10

[DISPLAY ALL EVENTS ADDED AT ER6]
[EVENT DATE, PROVIDER]
FOR FIRST/NEXT EVENT ENTERED AT MP6, IF (PROVIDER SPECIALTY IS A MEDICAL DOCTOR) AND ((EVENT
DATE OVERLAPS AN EXISTING IP EVENT) OR (EVENT DATE MATCHES AN EXISTING ER OR OP EVENT), GO TO
MP6B - MPSDVIS.
ELSE GO TO BOX MP2C.

(01) ADD ANOTHER
(02) ALL DONE

(01) ITEM SELECTED IN INSTANCE NAVIGATOR
(02) CONTINUE INTERVIEW SELECTED

(01) YES
We have recorded that in (EVENT MONTH) [you were/(SP) was] also in (READ EVENT(S) LISTED BELOW). Was
(02) NO
this visit with (PROVIDER NAME) a visit while [you were/(SP) was] in [the [READ EVENT LISTED BELOW]/any of
(-8) Don't Know
these places]?
(-9) Refused
UPDATE EVENT TYPE TO SEPARATELY BILLING DOCTOR AND GO TO BOX MP6.
IF PROVIDER SPECIALTY = Dentist, Medical Doctor, Optometrist, Osteopath, Paramedic, PhysicianAssistant,
Podiatrist, Other, DK or RF, GO TO MP7 - ANYOPERS.
ELSE GO TO MP10 - SPECCOND.
Were any operations or other surgical procedures performed on [you/(SP)] during [any of the/the] [VISIT ON
(01) YES
EVENT DATE]?
(02) NO
(-8) Don't Know
[Operations include surgery and other surgical procedures like setting bones, stitching or removing growths,
(-9) Refused
or any cutting of the skin.]
(01) YES
(02) NO
[Was this visit/Were any of these visits] to (PROVIDER NAME) for any specific condition?
(-8) Don't Know
(-9) Refused

BOX MP2D

PRESMDCN

MP12

IF CURRENTLY ADMINISTERING ST, GO TO BOX ST23B.
ELSE IF CURRENTLY ADMINISTERING NS, GO TO BOX NS23B.
ELSE GO TO MP12 - PRESMDCN.
During [this visit/any of these visits] to (PROVIDER NAME), were any medicines prescribed for [you/(SP)]?
Were any of the prescriptions filled?

PRESFILL

MP13

BOX MP3A

MPPMMEDS

MP13A

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

[COUNT A MEDICINE AS "FILLED" REGARDLESS OF WHO OBTAINED IT FOR THE RESPONDENT, WHEN IT WAS
OBTAINED, WHETHER OR NOT THE PRESCRIPTION COST ANYTHING, AND WHETHER OR NOT THE
RESPONDENT ACTUALLY TOOK THE MEDICINE.]
IF THE PROBE FOR PRESCRIPTION MEDICINE BOTTLES HAS NOT BEEN ASKED IN THE CURRENT ROUND, GO TO
MP13A - MPPMMEDS.
ELSE GO TO MP14 - MEDICINE_MP.
It would be helpful if I could look at any medicine bottle(s), container(s), or bag(s) that you have so that I can
spell the medicine name correctly and enter the strength of the medicine. [Also, please take out [your/(SP's)]
(MEDICARE PRESCRIPTION DRUG PLAN NAME) medicine statements, which should have that same
(01) CONTINUE
information on them.]
(-7) Empty
[IF RESPONDENT HAS BOTTLE, ASK:] I’ll need that same information for all of the medicines [you/(SP)]
obtained since the last interview, if you’d like to get those bottles, too.

(01) [Continuous answer.]
Please tell me the names of these medicines.
ENTER ALL MEDICINE NAMES.
CHECK STATEMENT OR MEDICINE BOTTLE FOR SPELLING.
MEDICINE_MP

MP14
[DISPLAY ROSTER WITH ALL MEDICINES FROM PRIOR ROUNDS (WHERE EVENT.EVNTTYPE='PM' AND
EVNTDFLG^=1)]
DISPLAY MEDICINE NAME (EVENT.PMEDNAME) AND STRENGTH (EVENT.PRMSTRUNI)

[DISPLAY MEDICINE ROSTER AS RESPONSE OPTIONS:
1. [MEDICINE 1]
2. [MEDICINE 2]
…
N. [MEDICINE N]
N+1. ADD ANOTHER
[DISPLAY MEDICINE NAME AND STRENGTH FOR EACH.
IF NO EXISTING MEDICINES DISPLAY "NO MEDICINES
LISTED"]

[AT TOP OF SCREEN DISPLAY LINK TO PRESCRIBED MEDICINE LOOKUP WITH LABEL "Search Medicine"]

MED

PMEDNAME
PMSTRUNI

MP14

Please tell me the names of these medicines.
ENTER ALL MEDICINES.
CHECK STATEMENT OR MEDICINE BOTTLE FOR SPELLING.

MP14
MP14

[DISPLAY ROSTER WITH ALL MEDICINES FROM PRIOR ROUNDS (WHERE EVENT.EVNTTYPE='PM' AND
EVNTDFLG^=1)]
DISPLAY MEDICINE NAME (EVENT.PMEDNAME) AND STRENGTH (EVENT.PRMSTRUNI)
NAME:
STRENGTH:

MEDID

MP14

ADDP

MP14B
BOX MP6

BOX MP6AA

MDOCMORE

MP17

BOX MP6A

MPPRPRAC

MP18

[THIS VARIABLE STORES THE UNIQUE IDENTIFIER FOR PRESCRIBED MEDICINES ADDED THROUGH THE
LOOKUP. IT IS HIDDEN ON SCREEN.]
MEDICATIONS FILLED DURING THIS VISIT
[DISPLAY ALL MEDICINES ADDED AT MED]
GO TO MP6_IN - NAVIGATOR.

(01) ADD ANOTHER
(02) ALL DONE

IF MEDICAL PROVIDER VISIT WAS REPORTED FOLLOWING MP1 PROBE, GO TO MP17 - MDOCMORE.
ELSE IF MEDICAL PROVIDER VISIT WAS REPORTED FOLLOWING MP18 PROBE, GO TO MP25 - PRACMORE.
ELSE IF MEDICAL PROVIDER VISIT WAS REPORTED FOLLOWING MP26 PROBE, GO TO MP33 - MENTMORE.
ELSE IF MEDICAL PROVIDER VISIT WAS REPORTED FOLLOWING MP34 PROBE, GO TO MP41 - THERMORE.
ELSE IF MEDICAL PROVIDER VISIT WAS REPORTED FOLLOWING MP42 PROBE, GO TO MP49 - PERSMORE.
ELSE IF MEDICAL PROVIDER VISIT WAS REPORTED FOLLOWING MP50 PROBE, GO TO MP56 - MPPRMORE.
[Since (REFERENCE DATE/UTILDATE)/Between (REFERENCE DATE) and (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION/ENDUTILD)], did [you/(SP)] have any other visits to this doctor or any other medical
doctor?
[DO NOT INCLUDE MEDICAL DOCTORS SEEN IN THE EMERGENCY ROOM, OUTPATIENT DEPARTMENT OR
CLINIC, AT THE RESPONDENT’S HOME, OR DURING AN INPATIENT STAY.]
IF WINTER ROUND AND (SP IS ALIVE AND NOT INSTITUTIONALIZED) AND (SP REPORTED A MEDICAL
PROVIDER VISIT AT MP6 AND MP6B - MPSDVIS ^= 1/Yes AND PROVIDER'S SPECIALTY IS A MEDICAL DOCTOR),
GO TO AC20 - MDSPCLTY.
ELSE GO TO MP18 - MPPRPRAC.
SHOW CARD MP1
(Besides what you have already mentioned), [(Since/since (REFERENCE DATE/UTILDATE)/(Between/between)
(REFERENCE DATE) and (DATE OF DEATH/DATE OF INSTITUTIONALIZATION/ENDUTILD), [have you/has
(SP)/did (SP)] [seen/see] a health practitioner like any of the ones listed on this card? [Health practitioners
include acupuncturist, audiologist, optometrist, chiropractor, podiatrist (foot doctor), homeopath,
naturopath, or any other kind of health provider who is not a medical doctor.]
INCLUDE ANY VISITS FOR TESTS/X-RAYS.

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

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

[DO NOT INCLUDE MEDICAL PROVIDERS SEEN IN THE EMERGENCY ROOM, OUTPATIENT DEPARTMENT OR
CLINIC, AT THE RESPONDENT’S HOME, OR DURING AN INPATIENT STAY.]

PRACMORE

MP25

[Since (REFERENCE DATE/UTILDATE)/Between (REFERENCE DATE) and (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION/ENDUTILD)], did [you/(SP)] have any other visits to this practitioner or any other
health practitioner?
[DO NOT INCLUDE MEDICAL PROVIDERS SEEN IN THE EMERGENCY ROOM, OUTPATIENT DEPARTMENT OR
CLINIC, AT THE RESPONDENT’S HOME, OR DURING AN INPATIENT STAY.]

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

SHOW CARD MP2

MPPRMENT

MP26

(Besides what you have already mentioned), [(Since/since (REFERENCE DATE/UTILDATE)/(Between/between)
(01) YES
(REFERENCE DATE) and (DATE OF DEATH/DATE OF INSTITUTIONALIZATION/ENDUTILD), [have you/has
(02) NO
(SP)/did (SP)] (seen/see) a mental health professional like any of the ones listed on this card? [Mental health
(-8) Don't Know
professional includes psychiatrist, psychologist, clinical social worker, and licensed professional counselor.]
(-9) Refused
[DO NOT INCLUDE PROVIDERS SEEN IN THE EMERGENCY ROOM, OUTPATIENT DEPARTMENT OR CLINIC, AT
THE RESPONDENT’S HOME, OR DURING AN INPATIENT STAY.]

MENTMORE

AFRDMT

MPPRTHER

THERMORE

MP33

MP33B

MP34

MP41

[Since (REFERENCE DATE/UTILDATE)/Between (REFERENCE DATE) and (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION/ENDUTILD)], did [you/(SP)] have any other visits to this professional or any other
mental health professional?
[DO NOT INCLUDE PROVIDERS SEEN IN THE EMERGENCY ROOM, OUTPATIENT DEPARTMENT OR CLINIC, AT
THE RESPONDENT’S HOME, OR DURING AN INPATIENT STAY.]
Since (REFERENCE DATE/UTILDATE)/Between (REFERENCE DATE) and (DATE OF
INSTITUTIONALIZATION/ENDUTILD)], was there any time when [you/(SP)] needed mental health care or
counseling, but [you/he/she] didn’t get mental health care because [you/he/she] couldn't afford it?

MP42

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

SHOW CARD MP3
(Besides what you have already mentioned), [(Since/since (REFERENCE DATE/UTILDATE)/(Between/between)
(REFERENCE DATE) and (DATE OF DEATH/DATE OF INSTITUTIONALIZATION/ENDUTILD), [have you/has
(01) YES
(SP)/did (SP)] (seen/see) a therapist like any of the ones listed on this card? [Therapist includes physical
(02) NO
therapist, speech therapist, intravenous (IV) therapist, massage therapist, occupational therapist, and
(-8) Don't Know
respiratory therapist.]
(-9) Refused
[DO NOT INCLUDE MEDICAL PROVIDERS SEEN IN THE EMERGENCY ROOM, OUTPATIENT DEPARTMENT OR
CLINIC, AT THE RESPONDENT’S HOME, OR DURING AN INPATIENT STAY.]
[Since (REFERENCE DATE/UTILDATE)/Between (REFERENCE DATE) and (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION/ENDUTILD)], did [you/(SP)] have any other visits to this therapist or any other
therapist?
[DO NOT INCLUDE MEDICAL PROVIDERS SEEN IN THE EMERGENCY ROOM, OUTPATIENT DEPARTMENT OR
CLINIC, AT THE RESPONDENT’S HOME, OR DURING AN INPATIENT STAY.]

MPPRPERS

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

SHOW CARD MP4
(Besides what you have already mentioned), [(Since/since (REFERENCE DATE/UTILDATE)/(Between/between)
(REFERENCE DATE) and (DATE OF DEATH/DATE OF INSTITUTIONALIZATION/ENDUTILD), [have you/has
(SP)/did (SP)] (seen/see) any other medical persons like the ones listed on this card? [Other medical persons
include nurse, nurse practitioner, paramedic, and physician’s assistant.]
[INCLUDE ANY VISITS FOR TESTS/X-RAYS.
DO NOT INCLUDE PROVIDERS SEEN IN THE EMERGENCY ROOM, OUTPATIENT DEPARTMENT OR CLINIC, AT
THE RESPONDENT’S HOME, OR DURING AN INPATIENT STAY.
DO NOT INCLUDE PARAMEDIC IF THE AMBULANCE WAS ONLY USED FOR TRANSPORTATION SERVICES.

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

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

PERSMORE

MP49

[Since (REFERENCE DATE/UTILDATE)/Between (REFERENCE DATE) and (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION)/ENDUTILD], did [you/(SP)] have any other visits to this person or any other medical
person?
[DO NOT INCLUDE PROVIDERS SEEN IN THE EMERGENCY ROOM, OUTPATIENT DEPARTMENT OR CLINIC, AT
THE RESPONDENT’S HOME, OR DURING AN INPATIENT STAY.]

MPPRPLAC

MP50

SHOW CARD MP5
(Besides what you have already mentioned), [(Since/since (REFERENCE
DATE/UNTILDATE)/(Between/between) (REFERENCE DATE) and (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION/ENDUTILD), [have you/has (SP)/did (SP)] (visited/visit) any other types of medical
places like the ones listed on this card? [Other types of medical places include health clinic, neighborhood
health center, rural health clinic, infirmary, mental health clinic, urgent care center, or any other place.]

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

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

[DO NOT INCLUDE VISITS TO THE EMERGENCY ROOM, OUTPATIENT DEPARTMENTS, INPATIENT STAYS, OR
SENIOR DAY CARE.]

MPPRMORE

MP56

[Since (REFERENCE DATE/UTILDATE)/Between (REFERENCE DATE) and (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION/ENDUTILD)], did [you/(SP)] have any other visits to this place or any other type of
medical place?
[DO NOT INCLUDE VISITS TO THE EMERGENCY ROOM, OUTPATIENT DEPARTMENTS, INPATIENT STAYS, OR
SENIOR DAY CARE.]

MCDRNSEE

SC11

TEMPCOND1

SC12AA

TEMPCOND2

SC12AA

TEMPCOND3

SC12AA

During (CURRENT YEAR), did [you/(SP)] have any health problem or condition about which you think
[you/he/she] should have seen a doctor or other health professional, but did not?
[INCLUDE ALL TYPES OF HEALTH PROBLEMS RANGING FROM MINOR TO SERIOUS ISSUES.]
What was the health problem or condition?
ENTER ALL CONDITIONS.
What was the health problem or condition?
ENTER ALL CONDITIONS.
What was the health problem or condition?
ENTER ALL CONDITIONS.

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) [Continuous answer.]
(01) [Continuous answer.]
(-7) Empty
(01) [Continuous answer.]
(-7) Empty

Did [you/(SP)] attempt to see a doctor or other health professional about this [READ CONDITION(S) BELOW]?

MCDRATMP

SC12A

(CONDITION 1 FROM SC12AA)
(CONDITION 2 FROM SC12AA)
(CONDITION 3 FROM SC12AA)
[PROBE: By "attempt" I mean, did [you/(SP)] contact a doctor’s office or other medical place in order to set an
appointment or talk to someone about the condition(s)?]

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

SHOW CARD MP6
This card lists some reasons people have given for not seeing a doctor or other health professional about a
health problem or condition.
Which of these reasons explains why [you/(SP)] did not see a doctor or other health professional about the
[READ CONDITION(S) BELOW]?
SCRCODES

SC13A
(CONDITION 1 FROM SC12AA)
(CONDITION 2 FROM SC12AA)
(CONDITION 3 FROM SC12AA)

SCROTOS

SC13A
BOX SC1B

[PROBE: Any other reason?]
CHECK ALL THAT APPLY.
OTHER (SPECIFY)
IF SC13A - SCRCODES INCLUDES MORE THAN ONE RESPONSE, GO TO SC14A - SCRMAIN.

Which of these was the main reason [you/(SP)] did not see a doctor or other health professional about (this
condition/these conditions) during (CURRENT YEAR) ?
[READ REASONS BELOW IF NECESSARY.]
SCRMAIN

SC14A
(CONDITION 1 FROM SC12AA)
(CONDITION 2 FROM SC12AA)
(CONDITION 3 FROM SC12AA)

(01) DIDN'T THINK THE PROBLEM WAS SERIOUS
(02) THOUGHT IT WOULD COST TOO MUCH
(03) TROUBLE FINDING/GETTING TO DOCTOR
(04) TIME/SCHEDULE OR PERSONAL CONFLICTS
(05) THOUGHT DOCTOR COULDN'T DO MUCH ABOUT
PROBLEM
(06) WAS AFRAID OF FINDING OUT WHAT WAS
WRONG
(07) DOCTOR WOULD NOT ACCEPT MY INSURANCE
(91) (OTHER/SC13A - SCROTOS OTHER SPECIFY TEXT)
(-8) Don't Know
(-9) Refused
(01) [Continuous answer.]
(01) DIDN'T THINK THE PROBLEM WAS SERIOUS
(02) THOUGHT IT WOULD COST TOO MUCH
(03) TROUBLE FINDING/GETTING TO DOCTOR
(04) TIME/SCHEDULE OR PERSONAL CONFLICTS
(05) THOUGHT DOCTOR COULDN'T DO MUCH ABOUT
PROBLEM
(06) WAS AFRAID OF FINDING OUT WHAT WAS
WRONG
(07) DOCTOR WOULD NOT ACCEPT MY INSURANCE
(91) (OTHER/SC13A - SCROTOS OTHER SPECIFY TEXT)
(-8) Don't Know
(-9) Refused