CMS-P-0015A Comm2018R82SCQ

Satisfaction with Care (SCQ)
Variable Name
MR Screen Name

Question type

Question text/description

Code list

SCQ SPECIFICATIONS
CRITERIA
INTTYPE=C001, C002, C003, C004, C005, C006
SPALIVE=1
SEASON=FALL
SPPROXY=SP or PROXY until BOX PA1
Other: N/A
PLACEMENT
Administer after NAQ.
SHOW CARD SC1

MCQUALTY

SC1

code 1

(01) VERY SATISFIED
(02) SATISFIED
We’re interested in how you feel about the health care [you have/(SP) has] received [over the past year/since
(03) DISSATISFIED
(TODAY'S DATE - 12 MONTHS, MONTH AND YEAR)] from doctors and hospitals. Please tell me how satisfied
(04) VERY DISSATISFIED
or dissatisfied you have been with the following:
(05) NOT APPLICABLE
(-8) Don't Know
The overall quality of the health care [you have /(SP) has] received [over the past year/since (TODAY'S DATE (-9) Refused
12 MONTHS)]. Have you been very satisfied, satisfied, dissatisfied, or very dissatisfied?
SHOW CARD SC1

MCAVAIL

SC2

code 1

[Please tell me how satisfied or dissatisfied you have been with . . .]
The availability of health care at night and on weekends.
SHOW CARD SC1

MCEASE

SC3

code 1

[Please tell me how satisfied or dissatisfied you have been with . . .]
The ease and convenience of getting to a doctor or other health professional from where [you/(SP)]
[live/lives].
SHOW CARD SC1

MCCOSTS

SC4

code 1

[Please tell me how satisfied or dissatisfied you have been with . . .]
The out-of-pocket costs [you/(SP)] paid for health care.

SHOW CARD SC1
MCINFO

SC5

code 1

[Please tell me how satisfied or dissatisfied you have been with . . .]
The information given to [you/you or (SP)] about what was wrong with [you/(SP)].

(01) VERY SATISFIED
(02) SATISFIED
(03) DISSATISFIED
(04) VERY DISSATISFIED
(05) NOT APPLICABLE
(-8) Don't Know
(-9) Refused
(01) VERY SATISFIED
(02) SATISFIED
(03) DISSATISFIED
(04) VERY DISSATISFIED
(05) NOT APPLICABLE
(-8) Don't Know
(-9) Refused
(01) VERY SATISFIED
(02) SATISFIED
(03) DISSATISFIED
(04) VERY DISSATISFIED
(05) NOT APPLICABLE
(-8) Don't Know
(-9) Refused
(01) VERY SATISFIED
(02) SATISFIED
(03) DISSATISFIED
(04) VERY DISSATISFIED
(05) NOT APPLICABLE
(-8) Don't Know
(-9) Refused

(01) VERY SATISFIED
(02) SATISFIED
(03) DISSATISFIED
[Please tell me how satisfied or dissatisfied you have been with . . .]
(04) VERY DISSATISFIED
(05) NOT APPLICABLE
The concern of doctors or other health professionals for [your/(SP’s)] overall health rather than just for an
(-8) Don't Know
isolated symptom or disease.
(-9) Refused
(01) VERY SATISFIED
(02) SATISFIED
SHOW CARD SC1
(03) DISSATISFIED
[Please tell me how satisfied or dissatisfied you have been with . . .]
(04) VERY DISSATISFIED
(05) NOT APPLICABLE
Getting all [your/(SP’s)] health care needs taken care of at the same location.
(-8) Don't Know
(-9) Refused
(01) VERY SATISFIED
(02) SATISFIED
SHOW CARD SC1
(03) DISSATISFIED
[Please tell me how satisfied or dissatisfied you have been with . . .]
(04) VERY DISSATISFIED
(05) NOT APPLICABLE
The availability of care by specialists when [you/(SP)] (feel/feels) (you/he/she) (need/needs) it.
(-8) Don't Know
(-9) Refused
(01) VERY SATISFIED
SHOW CARD SC1
(02) SATISFIED
(03) DISSATISFIED
[Please tell me how satisfied or dissatisfied you have been with . . .]
(04) VERY DISSATISFIED
(05) NOT APPLICABLE
The ease of obtaining answers to questions over the telephone about [your/(SP’s)] treatment or
(-8) Don't Know
prescriptions.
(-9) Refused
(01) RESPONDENT IS NOT DISSATISFIED WITH
Please think about all of the health care services [you/(SP)] [receive/receives], including services provided by
ANYTHING
doctors or other health professionals, hospitals and pharmacies.
(91) RESPONDENT IS DISSATISFIED (RECORD
VERBATIM IN THE NEXT SCREEN)
What things, if anything, about the health care services [you/(SP)] [receive/receives] are you dissatisfied
(-8) Don't Know
with?
(-9) Refused
[Please think about all of the health care services [you/(SP)] (receive/receives), including services provided by
doctors or other health professionals, hospitals and pharmacies.
(01) [Continuous answer.]
What things, if anything, about the health care services [you/(SP)] (receive/receives) are you dissatisfied
with?]
SHOW CARD SC1

MCCONCRN

SC7

code 1

MCSAMLOC

SC8

code 1

MCSPECAR

SC8A

code 1

MCTELANS

SC8B

code 1

MDISSFY

SC9

verbatim text

MCDISVB

SC9

verbatim text

Please tell me whether each of the following statements is true or false.
MCWORRY

SC10A

list

[You/(SP)] (worry/worries) about (your/his/her) health more than other people (your/his/her) age.
[Is this statement true or false?]
[Please tell me whether each of the following statements is true or false.]

MCAVOID

SC10A

list
[You/(SP)] will do just about anything to avoid going to the doctor.
[Please tell me whether each of the following statements is true or false.]

MCSICK

SC10A

list
When [you/(SP)] [are/is] sick, [you/he/she] [try/tries] to keep it to [yourself/himself/herself].

(01) TRUE
(02) FALSE
(-8) Don't Know
(-9) Refused
(01) TRUE
(02) FALSE
(-8) Don't Know
(-9) Refused
(01) TRUE
(02) FALSE
(-8) Don't Know
(-9) Refused

[Please tell me whether each of the following statements is true or false.]
MCDRSOON

SC10A

list

BOX PA1

(01) TRUE
(02) FALSE
Usually, [you/(SP)] (go/goes) to the doctor or other health professional as soon as (you/he/she) (start/starts) (-8) Don't Know
to feel bad.
(-9) Refused
IF IN4-SPPROXY=1/SP then go to PAINTRO- PAINTRO. ELSE GO TO BOX SCEND
Now I have some questions about how you make health care decisions. Answers to questions like these will
help Medicare better understand how people use medical services.

PAINTRO

PAINTRO

no entry
Please keep in mind that there are no right or wrong answers to these questions. Your opinions and
experiences are important to us.
SHOW CARD SC2
Please use this card to respond to the following statements.

PACHGDRS

code 1
How likely are you to change doctors or other health professionals if you are dissatisfied with the way you
and your doctor or other health professional communicate?

PA5

PADISAGR

code 1

SHOW CARD SC2
How likely are you to tell your doctor or other health professional when you disagree with him or her?

PA6
SHOW CARD SC3

PARXINFO

code 1

PA10

PADRQUEX

code 1
PA11

PAANSWR

code 1
PA12

PALISTRX

code 1

PA13

(01) CONTINUE
(-7) Empty

(01) VERY LIKELY
(02) LIKELY
(03) UNLIKELY
(04) VERY UNLIKELY
(-8) Don't Know
(-9) Refused
(01) VERY LIKELY
(02) LIKELY
(03) UNLIKELY
(04) VERY UNLIKELY
(-8) Don't Know
(-9) Refused

(01) ALWAYS
(02) USUALLY
These next questions are about practices sometimes associated with receiving medical care. Please tell me if
(03) SOMETIMES
you always, usually, sometimes, or never do the following:
(04) NEVER
(-8) Don't Know
Do you always, usually, sometimes, or never read information about a new prescription, such as side effects
(-9) Refused
and precautions?
(01) ALWAYS
SHOW CARD SC3
(02) USUALLY
Do you always, usually, sometimes, or never...
(03) SOMETIMES
(04) NEVER
Bring with you to your doctor or other health professional visits a list of questions or concerns you want to
(-8) Don't Know
cover?
(-9) Refused
(01) ALWAYS
SHOW CARD SC3
(02) USUALLY
[Do you always, usually, sometimes, or never...]
(03) SOMETIMES
(04) NEVER
Leave your doctor or other health professional's office feeling that all of your concerns or questions have
(-8) Don't Know
been fully answered?
(-9) Refused
(01) ALWAYS
(02) USUALLY
SHOW CARD SC3
(03) SOMETIMES
[Do you always, usually, sometimes, or never...]
(04) NEVER
(05) NOT APPLICABLE
Take a list of all of your prescribed medicines to your doctor or other health professional visits?
(-8) Don't Know
(-9) Refused

SHOW CARD SC3
[Do you always, usually, sometimes, or never...]
PATRSLT

code 1
Make sure you understand the results of any medical test or procedure such as an x-ray, blood test, or EKG
for heart conditions?

PA14

SHOW CARD SC3
[Do you always, usually, sometimes, or never...]
PAOPTION

code 1
Talk with your doctor or other health professional about your options if you need tests, follow-up care, or a
referral for care by a medical specialist?

PA15

PADVICE

code 1

SHOW CARD SC3
[Do you always, usually, sometimes, or never...]
Contact your doctor or other health professional's office to get medical advice when you need it.

PA21
BOX SCEND

routing

IF INTTYPE in(C001, C002, C004, C005, C006), GO TO END.
IF INTTYPE in(C003), GO TO DIQ.

(01) ALWAYS
(02) USUALLY
(03) SOMETIMES
(04) NEVER
(-8) Don't Know
(-9) Refused
(01) ALWAYS
(02) USUALLY
(03) SOMETIMES
(04) NEVER
(-8) Don't Know
(-9) Refused
(01) ALWAYS
(02) USUALLY
(03) SOMETIMES
(04) NEVER
(-8) Don't Know
(-9) Refused