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RCS: DD-HA(A) 1942 |
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Health Care Survey of DoD Beneficiaries A world-wide survey of beneficiaries eligible for health care coverage through the military health system March 2024 |
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PRIVACY ADVISORY Providing information in this survey is voluntary. There is no penalty nor will your benefits be affected if you choose not to respond, although maximum participation is encouraged so that the data will be complete and representative. The survey was written so that answers should not require you to provide any personally identifiable information (PII), but please be assured that any PII provided will be treated as confidential. Your responses are collected via a secure system which does not collect any information that could be used to determine your identity. Answering the questions is voluntary; you may stop the survey at any time. |
AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, xxxx-xxxx, is estimated to average xx minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at [email protected]. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.
OMB
CONTROL NUMBER: XXXX-XXXX
OMB EXPIRATION DATE: XX/XX/XXXX
SURVEY INSTRUCTIONS
Answer all the questions by filling in the circle to the left of your answer. You are sometimes told to skip over some questions in this survey. When this happens you will see an arrow with a note that tells you what question to answer next, like this:
Yes 4 Go to Question 12
No
Please return the completed questionnaire in the enclosed postage-paid envelope within seven days. If the envelope is missing, please send to:
Office of the Assistant Secretary of Defense (Health Affairs)
DHA, Analytics and Evaluation Division
c/o DataStat, Inc.
3975 Research Park Dr.
Ann Arbor, MI 48108
SURVEY STARTS HERE
As an eligible TRICARE beneficiary, please complete this survey even if you did not receive your health care from a military facility.
Please recognize that some specific questions about TRICARE benefits may not apply to you, depending on your entitlement and particular TRICARE program.
This survey is about the health care of the person whose name appears on the cover letter. The survey should be completed by that person. If you are not the addressee, please give this survey to that person.
1. Are you the person whose name appears on the cover letter?
Yes 4 Go to Question 2 on the next page
No 4 Please give this questionnaire to the person addressed on the cover letter.
currently covered?
MARK
ALL THAT APPLY.
Military
Health Plans
TRICARE Prime (including most Active Duty, TRICARE Prime Remote and TRICARE Overseas)
TRICARE Select (previously known as TRICARE Extra or Standard (CHAMPUS))
TRICARE Plus
TRICARE for Life
TRICARE Supplemental Insurance
TRICARE Reserve Select
TRICARE Retired Reserve
TRICARE Young Adult Prime
TRICARE Young Adult Select
Uniformed Services Family Health Plan (USFHP)
Continued Health Care Benefit Program (CHCBP) (a COBRA-like premium-based health care program)
Other Health Plans
Medicare
Federal Employees Health Benefit Program (FEHBP)
Medicaid or other state health insurance
A civilian HMO (such as Kaiser)
Other civilian health insurance (such as Blue Cross)
The Veterans Administration (VA)
Government health insurance from a country other than the US
Not sure
3. Which health plan did you use for all or most of your health care in the last 12 months?
MARK
ONLY ONE.
Military
Health Plans
TRICARE Prime (including most Active Duty, TRICARE Prime Remote and TRICARE Overseas)
TRICARE Select (previously known as TRICARE Extra or Standard (CHAMPUS))
TRICARE Plus
TRICARE Supplemental Insurance
TRICARE Reserve Select
TRICARE Retired Reserve
TRICARE Young Adult Prime
TRICARE Young Adult Select
Uniformed Services Family Health Plan (USFHP)
Continued Health Care Benefit Program (CHCBP) (a COBRA-like premium-based health care program)
Other Health Plans
Medicare
Federal Employees Health Benefit Program (FEHBP)
Medicaid or other state health insurance
A civilian HMO (such as Kaiser)
Other civilian health insurance (such as Blue Cross)
The Veterans Administration (VA)
Government health insurance from a country other than the US
Not sure 3 Go to Question 5
Did not use any health plan in the last 12 months 3 Go to Question 5
For the remainder of this questionnaire, the term health plan refers to the plan you indicated in Question 3. The next questions ask about your experience with your health plan.
4. How many months or years in a row have you been in this health plan?
Less than 6 months
At least 6 months but less than 12 months
At least 12 months but less than 24 months
At least 2 years but less than 5 years
At least 5 years but less than 10 years
10 or more years
information in written materials or on the Internet about how your health plan works?
Yes
No 4 Go to Question 7
6. In the last 12 months, how often did the written materials or the Internet provide the information you needed about how your plan works?
Never
Sometimes
Usually
Always
I didn't look for information from my health plan in the last 12 months.
7. Sometimes people need services or equipment beyond what is provided in a regular or routine office visit, such as care from a specialist, physical therapy, a hearing aid, or oxygen.
In the last 12 months, did you look for information from your health plan on how much you would have to pay for a health care service or equipment?
Yes
No 4 Go to Question 9
8. In the last 12 months, how often were you able to find out from your health plan how much you would have to pay for a health care service or equipment?
Never
Sometimes
Usually
Always
I didn't need a health care service or
equipment from my health plan in the last 12 months.
9. In some health plans, the amount you pay for a prescription medicine can be different for different medicines, or can be different for prescriptions filled by mail instead of at the pharmacy.
In the last 12 months, did you look for information from your health plan on how much you would have to pay for specific prescription medicines?
Yes
No 4 Go to Question 11
I didn't need prescription medications in the last 12 months. 4 Go to Question 12
10. In the last 12 months, how often were you able to find out from your health plan how much you would have to pay for specific prescription medications?
Never
Sometimes
Usually
Always
I
didn't need prescription medications in the
last 12 months. 4
Go to Question 12
11. In the last 12 months, how often was it difficult to pay for each of the following types of prescription medications you needed?
a. Medications as part of counseling or mental health treatment
Never
Sometimes
Usually
Always
I didn't need any of these medications
b. All other medications
Never
Sometimes
Usually
Always
I didn't need any of these medications
12. In the last 12 months, did you try to get
information or help from your health plan's customer service?
Yes
No 4 Go to Question 15
13. In the last 12 months, how often did your
health plan's customer service give you the information or help you needed?
Never
Sometimes
Usually
Always
I didn't call my health plan's customer service in the last 12 months.
Never
Sometimes
Usually
Always
I didn't call my health plan's customer service in the last 12 months.
15. In the last 12 months, did your health plan give you any forms to fill out?
Yes
No 4 Go to Question 17
16. In the last 12 months, how often were the forms from your health plan easy to fill out?
Never
Sometimes
Usually
Always
I didn't have any experiences with paperwork for my health plan in the last 12 months.
17. Claims are sent to a health plan for payment. You may send in the claims yourself, or doctors, hospitals, or others may do this for you. In the last 12 months, did you or anyone else send in any claims to your health plan?
Yes
No 4 Go to Question 20
Don't know 4 Go to Question 20
18. In the last 12 months, how often did your health plan handle your claims quickly?
Never
Sometimes
Usually
Always
Don't know
No claims were sent for me in the last 12 months.
19. In the last 12 months, how often did your
health plan handle your claims correctly?
Never
Sometimes
Usually
Always
Don't know
No claims were sent for me in the last 12 months.
20. Using any number from 0 to 10, where 0 is the worst health plan possible and 10 is the best health plan possible, what number would you use to rate your health plan?
0 Worst health plan possible
1
2
3
4
5
6
7
8
9
10 Best health plan possible
21. Using any number from 0 to 10, where 0 is not at all likely and 10 is extremely likely, how likely is it that you would recommend your health plan to a friend or family member?
0 Not at all likely
1
2
3
4
5
6
7
8
9
10 Extremely likely
HEALTH
CARE IN THE
LAST 12 MONTHS
These questions ask about your own health care. Do not include care you got when you stayed overnight in a hospital. Do not include the times you went for dental care visits.
22. In the last 12 months, where did you go most often for your health care?
MARK ONLY ONE.
A military facility - This includes: Military clinic, Military hospital, PRIMUS clinic, NAVCARE clinic
A civilian facility - This includes: Doctor's office, Clinic, Hospital, Civilian TRICARE contractor
Uniformed Services Family Health Plan facility (USFHP)
Veterans Affairs (VA) clinic or hospital
I went to none of the listed types of facilities in the last 12 months
Yes
No 3 Go to Question 26
24. In the last 12 months, when you needed care right away, how often did you get care as soon as you needed?
Never
Sometimes
Usually
Always
I didn't need care right away for an illness, injury, or condition in the last 12 months.
25. In the last 12 months, when you needed care right away for an illness, injury, or condition, how long did you usually have to wait between trying to get care and actually seeing a provider?
Same day
1 day
2 days
3 days
4 - 7 days
8 - 14 days
15 days or longer
I didn't need care right away for an illness, injury, or condition in the last 12 months.
26. In the last 12 months, did you make any in person, phone, or video appointments for a check up or routine care?
Yes
No 3 Go to Question 29
27. In the last 12 months, how often did you get an appointment for a check-up or routine care as soon as you needed?
Never
Sometimes
Usually
Always
I had no appointments in the last 12 months.
28. In the last 12 months, not counting the times you needed health care right away, how many days did you usually have to wait between making an appointment and actually seeing a provider?
Same day
1 day
2 - 3 days
4 - 7 days
8 - 14 days
15 - 30 days
31 days or longer
I had no appointments in the last 12 months.
29. In the last 12 months, how many times did you go to an emergency room to get care for yourself?
None
1
2
3
4
5 - 9
10 or more
30. In the last 12 months, not counting times you went to an emergency room, how many times did you get health care for yourself in person, by phone, or by video?
None 3 Go to Question 35
1
2
3
4
5 - 9
10 or more
31. In the last 12 months, how often did you and a doctor or other health provider talk about specific things you could do to prevent illness?
Never
Sometimes
Usually
Always
32. Choices for your treatment or health care can include choices about medicine, surgery, or other treatment. In the last 12 months, did a doctor or other health provider tell you there was more than one choice for your treatment or health care?
Yes
No 3 Go to Question 35
Definitely yes
Somewhat yes
Somewhat no
Definitely no
34. In the last 12 months, when there was more than one choice for your treatment or health care, did a doctor or other health provider ask which choice you thought was best for you?
Definitely yes
Somewhat yes
Somewhat no
Definitely no
35. Using any number from 0 to 10, where 0 is the worst health care possible and 10 is the best health care possible, what number would you use to rate all your health care in the last 12 months?
0 Worst health care possible
1
2
3
4
5
6
7
8
9
10 Best health care possible
I had no visits in the last 12 months.
36. In the last 12 months, how often was it easy to get the care, tests, or treatment you needed?
Never
Sometimes
Usually
Always
I didn't need care, tests, or treatment in the last 12 months.
YOUR PERSONAL DOCTOR
37. A personal doctor is the one you would talk to if you need a checkup, want advice about a health problem, or get sick or hurt. Do you have a personal doctor?
Yes
No 4 Go to Question 46
38. In the last 12 months, how many times did you
have an in person, phone, or video visit with your personal doctor about your health?
None 4 Go to Question 45
1
2
3
4
5 - 9
10 or more
39. In the last 12 months, how often did your personal doctor listen carefully to you?
Never
Sometimes
Usually
Always
I had no visits in the last 12 months.
40. In the last 12 months, how often did your personal doctor explain things in a way that was easy to understand?
Never
Sometimes
Usually
Always
I had no visits in the last 12 months.
41. In the last 12 months, how often did your personal doctor show respect for what you had to say?
Never
Sometimes
Usually
Always
I had no visits in the last 12 months.
42. In the last 12 months, how often did your personal doctor spend enough time with you?
Never
Sometimes
Usually
Always
I had no visits in the last 12 months.
43. In the last 12 months, did you get care from a doctor or other health provider besides your personal doctor?
Yes
No 4 Go to Question 45
Never
Sometimes
Usually
Always
45. Using any number from 0 to 10, where 0 is the worst personal doctor possible and 10 is the best personal doctor possible, what number would you use to rate your personal doctor?
0 Worst personal doctor possible
1
2
3
4
5
6
7
8
9
10 Best personal doctor possible
I don't have a personal doctor.
GETTING
HEALTH CARE
FROM A SPECIALIST
When you answer the next questions, include the care you got in person, by phone, or by video. Do not include dental visits or care you got when you stayed overnight in a hospital
46. Specialists are doctors like surgeons, heart doctors, allergy doctors, skin doctors, and other doctors who specialize in one area of health care.
In the last 12 months, did you make any appointments to see a specialist?
Yes
No 4 Go to Question 50
47. In the last 12 months, how often did you get an appointment to see a specialist as soon as you needed?
Never
Sometimes
Usually
Always
I didn't need a specialist in the last 12 months.
48. How many specialists have you talked to in the last 12 months?
None 4 Go to Question 50
1 specialist
2
3
4
5 or more specialists
49. We want to know your rating of the specialist you talked to most often in the last 12 months. Using any number from 0 to 10, where 0 is the worst specialist possible and 10 is the best specialist possible, what number would you use to rate the specialist?
0 Worst specialist possible
1
2
3
4
5
6
7
8
9
10 Best specialist possible
I didn't talk to a specialist in the last 12 months.
50. In general, how would you rate your overall mental or emotional health?
Excellent
Very Good
Good
Fair
Poor
51. In the last 12 months, did you need any mental health treatment or counseling for a personal or family problem?
Yes
No 4 Go to Question 57
52. In the last 12 months, how much of a problem, if any, was it to get the mental health treatment or counseling you needed through your health plan?
A big problem
A small problem
Not a problem
53. In the last 12 months, did you make any appointments for counseling or mental health treatment?
Yes
No 4 Go to Question 55
health treatment as soon as you needed?
Never
Sometimes
Usually
Always
I did not make any counseling or mental health treatment appointments.
55. For each statement, please mark whether it was one of the reasons why you did not make or had difficulty making any counseling or mental health treatment appointments.
MARK ALL THAT APPLY.
Was not ready to start treatment.
Had problems getting appointments because of difficulty getting time off from work.
Had problems with things like transportation, childcare, or getting appointments at times that worked for me.
Was worried about what people would think or say if I got treatment.
Concerned about the costs.
Did not know how or where to get treatment.
Could not find a treatment program or health care professional I wanted to go to.
There were no openings in the treatment program or with the health care professional
I wanted to go to.
Other
I had no difficulty making any counseling or mental health treatment appointments.
56. Using any number from 0 to 10 where 0 is the worst treatment or counseling possible and 10 is the best treatment or counseling possible, what number would you use to rate your treatment or counseling in the last 12 months?
0 Worst treatment or counseling possible
1
2
3
4
5
6
7
8
9
10 Best treatment or counseling possible
I had no treatment or counseling in the last 12 months.
PREVENTIVE CARE
Preventive care is medical care you receive that is intended to maintain your good health or prevent a future medical problem. A physical or blood pressure screening are examples of preventive care.
57. When did you last have a blood pressure reading?
Less than 12 months ago
1 to 2 years ago
More than 2 years ago
58. Is your blood pressure is too high?
Yes, it is too high
No, it is not too high
Don't know
59. When did you last have a flu shot?
Less than 12 months ago
1 to 2 years ago
More than 2 years ago
Never had a flu shot
60. How much of the time do you think you can trust the health care system to do what is right for you or your community?
Almost all of the time
Most of the time
Some of the time
Almost none of the time
61. Have you ever smoked at least 100 cigarettes in your entire life?
Yes
No
Don't know
62. Do you now smoke cigarettes or use tobacco every day, some days, or not at all?
Every day
Some days
Not at all 4 Go to Question 67
Don't know 4 Go to Question 67
63. In the last 12 months, how often were you advised to quit smoking or using tobacco by a doctor or other health provider in your plan?
Never
Sometimes
Usually
Always
Never
Sometimes
Usually
Always
65. In the last 12 months, how often did your doctor or health provider discuss or provide methods and strategies other than medication to assist you with quitting smoking or using tobacco? Such as: telephone helpline, individual or group counseling, or cessation program.
Never
Sometimes
Usually
Always
66. On the days you smoke or use tobacco products, what type of product do you smoke or use?
MARK ALL THAT APPLY.
Cigarettes
Dip, chewing tobacco, snuff, or snus
Cigars
Pipes, bidis, or kreteks (Pipes include hookahs. Bidis are small, brown, hand-rolled cigarettes from India and other Southeast Asian countries. Kreteks are clove cigarettes made in Indonesia that contain clove extract and tobacco.)
67. Are you male or female by birth?
Male 3 Go to Question 74
Female
68. When did you last have a Pap smear test?
Within the last 12 months
1 to 2 years ago
More than 2 but less than 3 years ago
More than 3 but less than 5 years ago
5 or more years ago
Never had a Pap smear test
69. Are you under age 40?
Yes 3 Go to Question 71
No
70. When was the last time your breasts were checked by mammography?
Within the last 12 months
1 to 2 years ago
More than 2 but less than 5 years ago
5 or more years ago
Never had a mammogram
71. Have you been pregnant in the last 12 months or are you pregnant now?
Yes, I am currently pregnant
No, I am not currently pregnant, but have
been pregnant in the past 12
months 3 Go to Question 73
No, I am not currently pregnant, and have
not been pregnant in the past 12
months 3 Go to Question 74
72. In what trimester is your pregnancy?
First trimester (up to 12 weeks after 1st day of last period) 3 Go to Question 74
Second trimester (13th through 27th week)
Third trimester (28th week until delivery)
73. In which trimester did you first receive prenatal care?
First trimester (up to 12 weeks after 1st day of last period)
Second trimester (13th through 27th week)
Third trimester (28th week until delivery)
Did not receive prenatal care
TELEHEALTH
Telehealth is phone call or video conference that links you to a provider at another location in order to assess, treat, and provide care to you remotely. When you answer the next questions, do not include dental visits.
74. In the last 12 months, did you have a telehealth appointment?
Yes
No 3 Go to Question 78
75. What type of telehealth care did you have? MARK ALL THAT APPLY.
Phone call
Video conferencing
Text/app messaging
MARK ALL THAT APPLY.
Preventive medical care
Urgent care
Medication/prescriptions
Counseling/talk therapy
In general, how satisfied were you with your telehealth care?
|
Satisfied |
Neither
|
Dissatisfied |
Booking the appointment |
O |
O |
O |
Ease of use |
O |
O |
O |
Quality of audio/visual connection |
O |
O |
O |
Wait
time at appointment |
O |
O |
O |
Communication with provider |
O |
O |
O |
Quality of care |
O |
O |
O |
Health needs met |
O |
O |
O |
Do you have a preference between using a telephone call, video conference, or text/app messaging for telehealth appointments?
Prefer telephone call
Prefer video conferencing
Prefer text/app messaging
No preference
79. Thinking about possible future appointment, would you prefer telehealth or in-person care for each of the following?
|
Prefer
|
Unsure
or preference |
Prefer
|
Urgent Care |
O |
O |
O |
Counseling/ talk therapy |
O |
O |
O |
Medication/ prescriptions |
O |
O |
O |
Preventive medical care (e.g., routine care or annual checkups) |
O |
O |
O |
CURRENT HEALTH
80. In general, how would you rate your overall health?
Excellent
Very good
Good
Fair
Poor
Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?
Please
write in "0" if there were none.
nn
NUMBER
OF DAYS
Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?
Please write in "0" if there were none. nn NUMBER OF DAYS
83. During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation?
Please write in "0" if there were none. nn NUMBER OF DAYS
MARK ALL THAT APPLY.
A heart attack
Angina or coronary heart disease
A stroke
Any kind of diabetes or high blood sugar
High cholesterol
Asthma, Chronic obstructive pulmonary disease (COPD), or Emphysema
Cancer
Osteoporosis
Depression or Anxiety
An autoimmune disease (e.g. Lupus, Celiac disease, Rheumatoid arthritis)
None of these
How tall are you without your shoes on?
Please give your answer in feet and inches. Please write one number in each box.
riFEET ri ri INCHES
How much do you weigh without your shoes on?
Please give your answer in pounds. Please write one number in each box.
riri ri POUNDS
LIVING SITUATION
87. Please select the option that best describes your current living situation.
I live on a military installation or in military housing
I live within 30 minutes of a military installation
I live within 60 minutes of a military installation
I live more than 60 minutes away from a military installation
88. Please select the option that best describes your current type of housing.
Government-owned military housing
Own
Rent
Other
89. Are you currently receiving the basic housing allowance?
Yes
No
90. Are you worried or concerned that in the next two months, you may not have stable housing that you own, rent, or stay in as part of a household?
Yes
No
91. Think about the place you live. Do you have problems with any of the following?
MARK ALL THAT APPLY.
Pests such as bugs, ants or mice
Mold
Lead paint or pipes
Lack of heat
Oven or stove not working
Smoke detectors missing or not working
Water leaks
None of the above
FINANCIAL SITUATION
92. What is your current work situation?
Retired
Employed full-time
Employed part-time
Unemployed, looking for work, or laid off
Not currently looking for work
93. How confident are you that you could come up with $400 if an unexpected expense arose within the next month?
Not at all confident
Not too confident
Somewhat confident
Very confident
94. How often has lack of transportation kept you from medical appointments, meetings, work, or
from getting things needed for daily living?
Often
Sometimes
Never
95. Within the past 12 months, you worried that your food would run out before you got money to buy more.
Often true
Sometimes true
Never true
96. Within the past 12 months, the food you bought just didn't last and you didn't have money to get more.
Often true
Sometimes true
Never true
ABOUT YOU
97. What is the highest grade or level of school that you have completed?
8th grade or less
Some high school, but did not graduate
High school graduate or GED
Some college or 2-year degree
4-year college graduate
More than 4-year college degree
98. What is your race and/or ethnicity?
Select all that apply and enter additional details in the spaces below.
American
Indian or Alaska Native –
Enter,
for example, Navajo Nation, Blackfeet Tribe of the Blackfeet Indian
Reservation of Montana, Native Village of Barrow Inupiat
Traditional Government, Nome Eskimo Community, Aztec, Maya, etc.
Asian – Provide details below.
m
Chinese m
Asian Indian m
Filipino
Enter, for example, Pakistani, Hmong, Afghan, etc.
m Vietnamese m Korean m Japanese
Black or African American – Provide details below.
m
African American m
Jamaican m
Haitian
Enter, for example, Trinidadian and Tobagonian, Ghanaian, Congolese, etc.
m Nigerian m Ethiopian m Somali
Hispanic or Latino – Provide details below.
m
Mexican m
Puerto Rican m
Salvadoran
Enter, for example, Colombian, Honduran, Spaniard, etc.
m Cuban m Dominican m Guatemalan
Middle Eastern or North African – Provide details below.
m
Lebanese m
Iranian m
Egyptian
Enter, for example, Moroccan, Yemeni, Kurdish, etc.
m Syrian m Iraqi m Israeli
Native Hawaiian or Pacific Islander – Provide details below.
m
Native Hawaiian m
Samoan m
Chamorro
Enter, for example, Chuukese, Palauan, Tahitian, etc.
m Tongan m Fijian m Marshallese
White – Provide details below.
m
English m
German m
Irish
Enter, for example, French, Swedish, Norwegian, etc.
m Italian m Polish m Scottish
99. What is your age now?
18 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 to 74
75 or older
THANK YOU
THANK
YOU FOR TAKING THE TIME TO
COMPLETE THE SURVEY!
Your
generous contribution will greatly aid efforts to
improve the
health of our military community.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Administrator |
File Modified | 0000-00-00 |
File Created | 2024-07-26 |