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Supplemental Items for the CAHPS Health Plan Child Survey 5.0/5.1: Children With Chronic Conditions

Population version: Child

Learn more about the CAHPS Children With Chronic Conditions Item Set.

Users of the CAHPS Health Plan Survey are free to incorporate supplemental items in order to meet the needs of their organizations, local markets, and/or audiences. Some items cover events that occur with low frequency in the general population. You should include them only if your sample design is likely to yield a sufficient number of responses to those questions for statistical analysis and reporting.

Questions in English Placement or Other Instructions
CC1. In the last 6 months, how often did you have your questions answered by your child’s doctors or other health providers?

1__ Never
2__ Sometimes
3__ Usually
4__ Always		 After core question 7

CC2. Choices for your child’s treatment or health care can include choices about medicine, surgery, or other treatment. In the last 6 months, did your child’s doctor or other health provider tell you there was more than one choice for your child’s treatment or health care?

1__ Yes
2__ No

 After CC1

Note: CC2—CC4 are not included in the HEDIS version of this survey.

CC3. In the last 6 months, did your child’s doctor or other health provider talk with you about the pros and cons of each choice for your child’s treatment or health care?

1__ Yes
2__ No

 After CC1

Note: Use with CC2. CC2—CC4 are not included in the HEDIS version of this survey.

CC4. In the last 6 months, when there was more than one choice for your child’s treatment or health care, did your child’s doctor or other health provider ask you which choice was best for your child?

1__ Yes
2__ No

 After CC1

Note: Use with CC2. CC2—CC4 are not included in the HEDIS version of this survey.

CC5. Is your child now enrolled in any kind of school or daycare?

1__ Yes
2__ No â†’ If No, go to #10 on page 2 [If items CC8-CC18 are included: go to #CC8]

 After core question 9

CC6. In the last 6 months, did you need your child’s doctors or other health providers to contact a school or daycare center about your child’s health or health care?

1__ Yes
2__ No â†’ If No, go to #10 on page 2 [If items CC8-CC18 are included: go to #CC8]

 After CC5

Note: Use with CC5

CC7. In the last 6 months, did you get the help you needed from your child’s doctors or other health providers in contacting your child’s school or daycare?

1__ Yes
2__ No

 After CC5

Note: Use with CC5 and CC6

CC8. Special medical equipment or devices include a walker, wheelchair, nebulizer, feeding tubes, or oxygen equipment. In the last 6 months, did you get or try to get any special medical equipment or devices for your child?

1__ Yes
2__ No â†’ If No, go to #CC11

 After core question 9 or CC7, if used.

CC9. In the last 6 months, how often was it easy to get special medical equipment or devices for your child?

1__ Never
2__ Sometimes
3__ Usually
4__ Always

 After CC8

Note: Use with CC8

CC10. Did anyone from your child’s health plan, doctor’s office, or clinic help you get special medical equipment or devices for your child?

1__ Yes
2__ No

 After CC9

Note: Use with CC8

CC11. In the last 6 months, did you get or try to get special therapy such as physical, occupational, or speech therapy for your child?

1__ Yes
2__ No â†’ If No, go to #CC14

 After CC10

CC12. In the last 6 months, how often was it easy to get this therapy for your child?

1__ Never
2__ Sometimes
3__ Usually
4__ Always

 After CC11

Note: Use with CC11

CC13. Did anyone from your child’s health plan, doctor’s office, or clinic help you get this therapy for your child?

1__ Yes
2__ No

 After CC12

Note: Use with CC11

CC14. In the last 6 months, did you get or try to get treatment or counseling for your child for an emotional, developmental, or behavioral problem?

1__ Yes
2__ No â†’ If No, go to #CC17

 After CC10

CC15. In the last 6 months, how often was it easy to get this treatment or counseling for your child?

1__ Never
2__ Sometimes
3__ Usually
4__ Always

 After CC14

Note: Use with CC14

CC16. Did anyone from your child’s health plan, doctor’s office, or clinic help you get this treatment or counseling for your child?

1__ Yes
2__ No

 After CC15

Note: Use with CC14

CC17. In the last 6 months, did your child get care from more than one kind of health care provider or use more than one kind of health care service?

1__ Yes
2__ No â†’ If No, go to core question #10

 After CC16

CC18. In the last 6 months, did anyone from your child’s health plan, doctor’s office, or clinic help coordinate your child’s care among these different providers or services?

1__ Yes
2__ No

 After CC17

Note: Use with CC17

CC19. Does your child have any medical, behavioral, or other health conditions that have lasted for more than 3 months?

1__ Yes
2__ No â†’ If No, go to core question #20

 After core question 19

CC20. Does your child’s personal doctor understand how these medical, behavioral, or other health conditions affect your child’s day-to-day life?

1__ Yes
2__ No

 After CC19

Note: Use with CC19

CC21. Does your child’s personal doctor understand how your child’s medical, behavioral, or other health conditions affect your family’s day-to-day life?

1__ Yes
2__ No

 After CC20

Note: Use with CC19

CC22. In the last 6 months, did you get or refill any prescription medicines for your child?

1__ Yes
2__ No â†’ If No, go to core question #30

 After core question 29

Note: Before CC22-CC24, add a new heading: Prescription Medicines

CC23. In the last 6 months, how often was it easy to get prescription medicines for your child through his or her health plan?

1__ Yes
2__ No

 After CC22

Note: Use with CC22

CC24. Did anyone from your child’s health plan, doctor’s office, or clinic help you get your child’s prescription medicines?

1__ Yes
2__ No

 After CC22

Note: Use with CC22

CC25. Does your child currently need or use medicine prescribed by a doctor (other than vitamins)?

1__ Yes
2__ No â†’ If No, go to #CC28

 After core question 31

CC26. Is this because of any medical, behavioral, or other health condition?

1__ Yes
2__ No â†’ If No, go to #CC28

 After CC25

Note: Use with CC25

CC27. Is this a condition that has lasted or is expected to last for at least 12 months?

1__ Yes
2__ No

 After CC26

Note: Use with CC25 and CC26

CC28. Does your child need or use more medical care, more mental health services, or more educational services than is usual for most children of the same age?

1__ Yes
2__ No â†’ If No, go to #CC31

 After CC27

CC29. Is this because of any medical, behavioral, or other health condition?

1__ Yes
2__ No â†’ If No, go to #CC31

 After CC28

Note: Use with CC28

CC30. Is this a condition that has lasted or is expected to last for at least 12 months?

1__ Yes
2__ No

 After CC29

Note: Use with CC28 and CC29

CC31. Is your child limited or prevented in any way in his or her ability to do the things most children of the same age can do?

1__ Yes
2__ No â†’ If No, go to #CC34

 After CC30

CC32. Is this because of any medical, behavioral, or other health condition?

1__ Yes
2__ No â†’ If No, go to #CC34

 After CC31

Note: Use with CC31

CC33. Is this a condition that has lasted or is expected to last for at least 12 months?

1__ Yes
2__ No

 After CC32

Note: Use with CC31 and CC32

CC34. Does your child need or get special therapy such as physical, occupational, or speech therapy?

1__ Yes
2__ No â†’ If No, go to #CC37

 After CC33

CC35. Is this because of any medical, behavioral, or other health condition?

1__ Yes
2__ No â†’ If No, go to #CC37

 After CC34

Note: Use with CC34

CC36. Is this a condition that has lasted or is expected to last for at least 12 months?

1__ Yes
2__ No

 After CC35

Note: Use with CC34 and CC35

CC37. Does your child have any kind of emotional, developmental, or behavioral problem for which he or she needs or gets treatment or counseling?

1__ Yes
2__ No â†’ If No, go to #CC32

 After CC33

CC38. Has this problem lasted or is it expected to last for at least 12 months?

1__ Yes
2__ No

 After CC37

Note: Use with CC37

 

Page last reviewed April 2022
Page originally created April 2022

Internet Citation: Supplemental Items for the CAHPS Health Plan Child Survey 5.0/5.1: Children With Chronic Conditions. Content last reviewed April 2022. ´óÏóÊÓƵ, Rockville, MD.
/cahps/surveys-guidance/item-sets/hp/suppl-CCC-items-hp-survey5-child.html

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