Survey Instruments and Associated Documentation

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1996 MEPS Household Component (HC) Survey Instrument: Rounds 1-5 

The 1996 MEPS HC data collection instrument is comprised of 44 separate sections that are divided according to specific topics. Each section contains a series of CAPI-Computer Assisted Personal Interviewing-computer screens with questions, interviewing instructions, and skip patterns based on the specific topics. These screens are provided in the following table as Portable Document Format (PDF) files.
 

To obtain a free diskette of the 1996 MEPS HC Questionnaire: Round 1, contact the AHRQ Publication Clearinghouse and specify AHCPR Pub. No. 97-DP02. 

To obtain a free diskette of the 1996 MEPS-HC Annotated Questionnaires: Panel 1, Rounds 1-5, contact  the AHRQ Publication Clearinghouse and specify AHRQ Pub. No. 01-DP03. 
 

Check the README file for more detailed information on the MEPS HC Data Collection Instrument.

1996 MEPS HC Interview Showcards: Rounds 1-3

During the household interview, the 1996 Showcards assist MEPS respondents by providing them with paper copy  versions of definitions or response categories that pertain to specific questionnaire items through out the Computer Assisted Personal Interview or CAPI. In the table below, the showcards for Panel 1, Rounds 1-3 and Panel 2, Round 1 are provided.

MEPS Household Component (HC) Paper Instruments

MEPS periodically administers self- or parent-administered questionnaires to supplement interviewers collected data.

Adult Self Administered Questionnaire (SAQ)

The Self-Administered Questionnaire (SAQ) was administered to all household respondents 18 years old and older during Round 4 of Panel 4 and Round 2 of Panel 5. The SAQ is a mail-back survey and includes questions from the Consumer Assessment of Health Plans (CAHPS®), the SF-12, the EuroQol 5D, and attitude items.

The 2000 Parent Administered Questionnaire (PAQ)

The Parent-Administered Questionnaire (PAQ) is a self-administered questionnaire administered to parents of children under 18 years of age. The PAQ is a mail-back survey fielded during Round 4 of Panel 4 and Round 2 of Panel 5 and includes questions from the Consumer Assessment of Health Plans (CAHPS®) and the Living with Illness Measure (LWIM).

A Survey About Your Diabetes Care

The Diabetes Care Survey (DCS) is a self-administered paper-and-pencil questionnaire first fielded in 2000. Households receive a DCS based on their response to a question in the Priority Condition section of the CAPI instrument, which asks whether or not the respondent was ever told by a doctor or health professional that he/she had diabetes.

Data Collection Schedule for MEPS HC Supplements

MEPS Supplements are survey instruments which focus on areas of policy interest. They are periodically rotated in and out of the MEPS HC.
The Data Collection Schedule for MEPS Supplements (PDF) or (HTML) is a chart outlining the specific panels and rounds in which particular topical supplements have been or will be administered.

1996 MEPS Nursing Home Component (NHC) Survey Instrument:
Rounds 1-3 

The 1996 MEPS NHC data collection instrument (used in the nursing home) encompasses 12 Computer Assisted Personal Interviewing (CAPI) questionnaires. Data were collected from community sources (via telephone) using a computer assisted interviewing questionnaire. A minor amount of data was collected from nursing home sources with paper instruments. These questionnaires are provided in the following table as Portable Document Format (PDF) files (excluding the paper instrument used to obtain names and addresses of potential community respondents).

 

General instrument information	Summary of Data Collection Activities collect.pdf	Overview of NHC instruments readme.htm	Acronyms and terms used in NHC instruments
Person Characteristics (obtained from NH sources)	Facility background and health insurance Questionnaires fb-hi.pdf	Health Status Questionnaire hlthstat.pdf	Facility Residence History res-his.pdf	Prescribed Medicines pmed.pdf
	Expenditures expend.pdf	Use of Services services.pdf	Person-Level Navigation Spec. nav-v3-1.pdf
Person Characteristics (from community sources)	Community Questionnaire communty.pdf
Facility Characteristics (obtained from sampled facility sources)	Facility-Level Questionnaire Round 1 fac-lvl.pdf	Sampled Facility Questionnaire Round 2 sam-fac2.pdf	Sampled Facility Questionnaire Round 3 sam-fac3.pdf
Facility Characteristics (from new facility sources)	New Facility Questionnaire Round 2 new-fac.pdf	New Facility and Continuing New Facility Questionnaire, Round 3 cnf-nffq.pdf

 

See Methodology Report #3: Design and Methods of the 1996 Medical Expenditure Panel Survey Nursing Home Component  for more detailed information on the MEPS NHC Data Collection Instrument.

To obtain a free diskette of the MEPS NHC Questionnaire: Round 1, contact  the AHRQ Publication Clearinghouse and specify AHCPR Pub. No. 97-DP03.

Because of confidentiality concerns, data collected from the  1996 MEPS NHC Questionnaire are only available in the CFACT Data Center.

Check the README file for more detailed information on the MEPS IC Data Collection Instrument.

The MEPS-IC data collection instrument for 2001 includes eight establishment level questionnaires and six government level questionnaires. The primary questionnaires for private-sector establishments and governments are provided as separate PDF and HTML files below.

The other questionnaires listed below collect similar information but use different wordings and question structures as they are used to collect under specific circumstances. Check the README file for more information about these forms and when they are used in the collection process. Copies of all MEPS IC forms are available upon request to the MEPS Project Officer mailbox at mepspd@ahrq.gov.
 

The MEPS-IC data collection instrument for 2002 includes eight establishment level questionnaires and six government level questionnaires. The primary questionnaires for private-sector establishments and governments are provided as separate PDF and HTML files below.

The other questionnaires listed below collect similar information but use different wordings and question structures as they are used to collect under specific circumstances. Check the README file for more information about these forms and when they are used in the collection process. Copies of all MEPS IC forms are available upon request to the MEPS Project Officer mailbox at mepspd@ahrq.gov.

Check the README file for more detailed information on the MEPS MPC Data Collection Instrument.

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