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Child Survey
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1.
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Our records show that your child
is in {Health Plan Name}. Is that right?
|
| 100% |
Yes
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-> Go to Question 3
|
| 0% |
No
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-> Go to Question 2
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3.
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Is this the health plan you use for all or most of your child's health care?
|
| 99% |
Yes
|
| 1% |
No
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4.
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How many months or years in a row has your child been in this health plan?
|
| 1% |
Less than 12 months
|
| 24% |
12 up to 24 months
|
| 46% |
2 up to 5 years
|
| 21% |
5 up to 10 years
|
| 7% |
10 or more years
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Your Child's Personal Doctor or Nurse
The next questions ask about your child's health care. Do not
include care your child got when he or she stayed overnight in a
hospital. Do not include the times your child went for dental care visits.
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5.
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A personal doctor or nurse is the health provider who knows your
child best. This can be a general doctor, a specialist doctor, a nurse
practitioner, or a physician assistant.
When your child joined this health plan or at any time since then, did
he or she get a new personal doctor or nurse?
|
| 41% |
Yes
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-> Go to Question 6
|
| 59% |
No
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-> Go to Question 7
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6.
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With the choices your child's health plan gave you, how much of a problem,
if any, was it to get a personal doctor
or nurse for your child you are happy with?
|
| 4% |
A big problem
|
| 22% |
A small problem
|
| 74% |
Not a problem
|
| 0% |
I didn't get a new personal doctor or nurse for my child.
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7.
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Do you have one person you think of as your child's personal
doctor or nurse? If your child has more than one personal
doctor or nurse, choose the person your child sees most often.
|
| 95% |
Yes
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-> Go to Question 8
|
| 5% |
No
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-> Go to Question 10
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8.
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In the last 12 months, when your child went to his or her personal doctor or
nurse's office or clinic, how often did the doctor or nurse talk with you about
how your child is feeling, growing, or behaving?
|
| 3% |
Never
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| 11% |
Sometimes
|
| 22% |
Usually
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| 64% |
Always
|
| 0% |
My child doesn't have a personal doctor or nurse.
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9.
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We want to know your rating of your child's personal doctor or nurse.
If your child has more than one personal doctor or nurse, choose the person
your child sees most often.
|
| 0% |
0 - Worst personal doctor or nurse possible
|
| 0% |
1
|
| 0% |
2
|
| 1% |
3
|
| 3% |
4
|
| 2% |
5
|
| 8% |
6
|
| 24% |
7
|
| 25% |
8
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| 36% |
9
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| 0% |
10 - Best personal doctor or nurse possible
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My child doesn't have a personal doctor or nurse.
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Getting Health Care From a Specialist
When you answer the next questions, do not include dental visits.
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10.
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Specialists are doctors like surgeons, heart doctors, allergy doctors, skin doctors, and others who specialize in one area of health care.
In the past 12 months, did you or a doctor think your child needed to see a specialist?
|
| 33% |
Yes |
Go to Question 11
|
| 67% |
No
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Go to Question 12
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11.
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In the last 12 months how much of a problem, if any was it to get a referral
to a specialist that your child needed to see?
|
| 7% |
A big problem
|
| 12% |
A small problem
|
| 81% |
Not a problem
|
| 0% |
My child didn't need to see a specialist in the last 12 months
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12. |
In the last 12 months, did your child see a specialist? |
| 31% |
Yes |
Go to Question 13
|
| 69% |
No
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Go to Question 15
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13. |
We want to know your rating of the specialist your child saw most
often in the last 12 month, including a personal doctor if he or she was a specialist.
Use any number from 0 to 10 where 0 is the worst personal doctor or
nurse possible, and 10 is the best personal doctor or nurse possible.
How would you rate your child's personal doctor or nurse now?
|
| 0% |
0 - Worst specialist possible
|
| 0% |
1
|
| 2% |
2
|
| 1% |
3
|
| 3% |
4
|
| 4% |
5
|
| 7% |
6
|
| 18% |
7
|
| 28% |
8
|
| 36% |
9
|
| 0% |
10 - Best specialist possible
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My child doesn't have a personal doctor or nurse.
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14.
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In the last 12 months, was the specialist your child saw most often
the same doctor as your child's personal doctor?
|
| 2% |
Yes |
| 98% |
No
|
| 0% |
My child doesn't have a personal doctor or didn't see a specialist in the last 12 months
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Calling Doctors' Offices
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15.
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In the last 12 months, did you call a doctor's office or clinic
during regular office hours to get help or advice you needed for your child?
|
| 83% |
Never |
| 17% |
Sometimes
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Usually
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Always
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I didn't call for help or advice for my child during regular office hours in the last 12 months.
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16.
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In the last 12 months, when you called during regular office hours, how often
did you get the help or advice you needed for your child?
|
| 1% |
Never |
| 6% |
Sometimes
|
| 22% |
Usually
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| 71% |
Always
|
| 0% |
I didn't call for help or advice for my child during regular
office hours in the last 12 months.
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Your Child's Health Care in the Last 12 Months
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17.
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A health provider could be a general doctor, a specialist doctor, a nurse practitioner, a physician assistant, a nurse, or anyone else your child would see for health care.
In the last 12 months, did you make any appointments for your child with a doctor or other health care provider for regular or routine health care?
|
| 82% |
Yes |
Go to Question 18
|
| 18% |
No
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Go to Question 20
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18.
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In the last 12 months, how often did your child get an appointment for
regular or routine health care as soon as you wanted?
|
| 1% |
Never |
| 5% |
Sometimes
|
| 32% |
Usually
|
| 62% |
Always
|
| 0% |
My child didn't need an appointment for regular or routine
health care in the last 12 months.
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19.
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In the last 12 months, how many days did your child usually have to wait
between making an appointment for regular or routine care and actually seeing a provider?
|
| 27% |
Same day |
| 13% |
1 day
|
| 17% |
2-3 days
|
| 13% |
4-7 days
|
| 14% |
8-14 days
|
| 9% |
15-30 days
|
| 8% |
31 days or longer
|
| 1% |
My child didn't need an appointment for regular or routine care in the last 12 months.
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20.
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In the last 12 months, did your child have an illness or
injury that needed care right away from a doctor's office, clinic, or emergency room?
|
| 60% |
Yes |
Go to Question 21
|
| 40% |
No
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Go to Question 23
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21.
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In the last 12 months, when your child needed care right away for an
illness or injury, how often did your child get care as soon as you wanted?
|
| 1% |
Never
|
| 4% |
Sometimes
|
| 19% |
Usually
|
| 76% |
Always
|
| 0% |
My child didn't need care right away for an illness or injury in the last 12 months.
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22.
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In the last 12 months, how long did your child usually have to wait
between trying to get care and actually seeing a provider for an
illness or injury?
|
| 75% |
Same day
|
| 18% |
1 day
|
| 4% |
2-3 days
|
| 1% |
4-7 days
|
| 1% |
8-14 days
|
| 1% |
15-30 days
|
| 0% |
31 days or longer
|
| 0% |
My child didn't need to get care right away for an illness or injury in the last 12 months.
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23.
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In the last 12 months, how many times did your child to go an emergency room?
|
| 28% |
None
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Number of times
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24.
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In the last 12 months, (not counting times your child went to an
emergency room), how many times did your child go to a doctor's office or clinic?
|
| 13% |
None |
Go to Question 37
|
| 21% |
1
|
Go to Question 25
|
| 20% |
2
|
Go to Question 25
|
| 15% |
3
|
Go to Question 25
|
| 21% |
4
|
Go to Question 25
|
| 6% |
5 to 9
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Go to Question 25
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10 or more
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Go to Question 25
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25.
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In the last 12 months, how much of a problem, if any, was it to
get care for your child that you or a doctor believed necessary?
|
| 1% |
A big problem
|
| 4% |
A small problem
|
| 94% |
Not a problem
|
| 0% |
My child had no visits in the last 12 months.
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26.
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In the last 12 months, how much of a problem, if any, were delays in your
child's health care while you waited for approval from your child's health plan?
|
| 3% |
A big problem
|
| 7% |
A small problem
|
| 90% |
Not a problem
|
| 0% |
My child had no visits in the last 12 months.
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27.
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In the last 12 months, how often did your child wait in the doctor's office or
clinic more than 15 minutes past the appointment time to see the person your child went to see?
|
| 28% |
Never
|
| 40% |
Sometimes
|
| 15% |
Usually
|
| 14% |
Always
|
| 3% |
I don't know
|
| 0% |
My child had no visits in the last 12 months.
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28.
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In the last 12 months, how often did office staff at your child's doctor's
office or clinic treat you and your child with courtesy and respect?
|
| 0% |
Never
|
| 2% |
Sometimes
|
| 16% |
Usually
|
| 81% |
Always
|
| 0% |
I don't know
|
| 0% |
My child had no visits in the last 12 months.
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29.
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In the last 12 months, how often were office staff at your child's doctor's
office or clinic as helpful as you thought they should be?
|
| 1% |
Never
|
| 7% |
Sometimes
|
| 28% |
Usually
|
| 65% |
Always
|
| 0% |
I don't know
|
| 0% |
My child had no visits in the last 12 months.
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30.
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In the last 12 months, how often did your child's doctors or other
health providers listen carefully to you?
|
| 0% |
Never
|
| 3% |
Sometimes
|
| 23% |
Usually
|
| 74% |
Always
|
| 0% |
I don't know
|
| 0% |
My child had no visits in the last 12 months.
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31.
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In the last 12 months, how often did your child's doctors or other
health providers explain things in a way you could understand?
|
| 0% |
Never
|
| 1% |
Sometimes
|
| 18% |
Usually
|
| 80% |
Always
|
| 0% |
I don't know
|
| 0% |
My child had no visits in the last 12 months.
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32.
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In the last 12 months, how often did your child's doctors or other
health providers show respect for what you had to say?
|
| 0% |
Never
|
| 4% |
Sometimes
|
| 21% |
Usually
|
| 75% |
Always
|
| 0% |
I don't know
|
| 0% |
My child had no visits in the last 12 months.
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33.
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Is your child old enough to talk with doctors about his or her health care?
|
| 62% |
Yes |
Go to Question 34
|
| 38% |
No
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Go to Question 35
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34.
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In the last 12 months, how often did doctors or other health
providers explain things in a way your child could understand?
|
| 1% |
Never
|
| 10% |
Sometimes
|
| 28% |
Usually
|
| 60% |
Always
|
| 1% |
I don't know
|
| 0% |
My child had no visits in the last 12 months or my child
is not old enough to talk with doctors.
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35.
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In the last 12 months, how often did doctors or other health
providers spend enough time in the last 12 months?
|
| 0% |
Never
|
| 6% |
Sometimes
|
| 31% |
Usually
|
| 62% |
Always
|
| 0% |
I don't know
|
| 0% |
My child had no visits in the last 12 months.
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36. |
We want to know your rating of all your child's health care in the
last 12 months from all doctors and other health providers.
Use any number from 0 to 10 where 0 is the worst health care possible,
and 10 is the best health care possible. How would you rate all your child's health care?
|
| 0% |
0 - Worst health care possible
|
| 0% |
1
|
| 0% |
2
|
| 1% |
3
|
| 3% |
4
|
| 3% |
5
|
| 10% |
6
|
| 24% |
7
|
| 26% |
8
|
| 33% |
9
|
| 0% |
10 - Best health care possible
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My child had no visits in the last 12 months.
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Your Child's Health Plan
The next questions ask about your experience with your child's health plan.
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33.
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Claims are sent to a health plan for payment. You may send in your child's claims yourself, or doctors, hospitals, or others may do this for your child.
In the last 12 months, did you or anyone else send in any claims for your child's health plan?
|
| 62% |
Yes |
Go to Question 38
|
| 38% |
No
|
Go to Question 41
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Don't know
|
Go to Question 41
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38.
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In the last 12 months, how often did your child's health plan handle
your child's claims in a reasonable time?
|
| 2% |
Never
|
| 12% |
Sometimes
|
| 39% |
Usually
|
| 42% |
Always
|
| 4% |
I don't know
|
| 0% |
No claims were sent to my child's health plan in the last 12 months.
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39.
|
In the last 12 months, how often did your child's health plan handle your child's claims correctly?
|
| 2% |
Never
|
| 13% |
Sometimes
|
| 37% |
Usually
|
| 46% |
Always
|
| 2% |
I don't know
|
| 0% |
No claims were sent to my child's health plan in the last 12 months.
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40.
|
In the last 12 months, before your child went for care, how often did
your child's health plan make it clear how much you would have to pay?
|
| 13% |
Never
|
| 6% |
Sometimes
|
| 25% |
Usually
|
| 47% |
Always
|
| 9% |
I don't know
|
| 0% |
No claims were sent to my child's health plan in the last 12 months.
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41.
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In the last 12 months, did you look for any information in
written materials from your child's health plan?
|
| 39% |
Yes |
Go to Question 42
|
| 61% |
No
|
Go to Question 43
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42.
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In the last 12 months, how much of a problem, if any, was it to find or
understand information in the written materials?
|
| 5% |
A big problem
|
| 39% |
A small problem
|
| 56% |
Not a problem
|
| 0% |
I didn't look for information from my child's health plan in the last 12 months.
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43.
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In the last 12 months, did you call the health plan's customer service
to get information or help for your child?
|
| 35% |
Yes |
Go to Question 44
|
| 65% |
No
|
Go to Question 45
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44.
|
In the last 12 months, how much of a problem, if any, was it to get the
help you needed when you called your child's health plan's customer service?
|
| 16% |
A big problem
|
| 31% |
A small problem
|
| 53% |
Not a problem
|
| 0% |
I didn't call my child's health plan's customer service in the last 12 months.
|
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45.
|
In the last 12 months, have you called or written to your child's
health plan with a complaint or problem?
|
| 17% |
Yes |
Go to Question 46
|
| 83% |
No
|
Go to Question 48
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46.
|
How long did it take for your child's health plan to resolve your complaint?
|
| 23% |
Same day |
Go to Question 47
|
| 16% |
2-7 days
|
Go to Question 47
|
| 10% |
8-14 days
|
Go to Question 47
|
| 11% |
15-21 days
|
Go to Question 47
|
| 16% |
More than 21 days
|
Go to Question 47
|
| 24% |
I am still waiting for it to be settled
|
Go to Question 48
|
| 0% |
I haven't called or written with a complaint or problem in the last 12 months.
|
Go to Question 48
|
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47.
|
Was your complaint or problem settled to your satisfaction?
|
| 75% |
No |
| 23% |
Yes
|
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I am still waiting for it to be settled
|
|
I haven't called or written with a complaint or problem in the last 12 months.
|
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48.
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Paperwork means things like getting your child's ID card, having your
child's records changed, processing forms, or other paperwork related to
getting care for your child.
In the last 12 months, did you have any experience with paperwork for your child's health
|
| 23% |
Yes |
Go to Question 49
|
| 77% |
No
|
Go to Question 50
|
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49.
|
In the last 12 months, how much of a problem, if any, did you have
with paperwork for your child's health plan?
|
| 3% |
A big problem
|
| 8% |
A small problem
|
| 89% |
Not a problem
|
| 0% |
I didn't have any experience with paperwork for my child's health plan in the last 12 months.
|
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50. |
We want to know your rating of all your experience with your child's health plan.
Use any number from 0 to 10 where 0 is the worst health plan possible, and 10 is the best health plan possible.
How would you rate your child's health plan now?
|
| 0% |
0 - Worst health plan possible
|
| 0% |
1
|
| 1% |
2
|
| 2% |
3
|
| 7% |
4
|
| 5% |
5
|
| 13% |
6
|
| 28% |
7
|
| 22% |
8
|
| 21% |
9
|
|
10 - Best health plan possible
|
|
My child had no visits in the last 12 months.
|
|
About Your Child and You
|
|
51. |
In general, how would you rate your child's overall health now?
|
| 52% |
Excellent
|
| 36% |
Very good
|
| 11% |
Good
|
| 1% |
Fair
|
| 0% |
Poor
|
|
52. |
What is your child's age now?
|
| 100% |
less than 1 year old
|
|
___ years old
|
|
53. |
Is your child male or female?
|
| 57% |
Male
|
| 43% |
Female
|
|
54. |
Is your child of Hispanic or Latino origin or descent?
|
| 4% |
Hispanic or Latino
|
| 96% |
Not Hispanic or Latino
|
|
55. |
What is your child's race? Please mark one or more.
|
|
White
|
|
Black or African-American
|
|
Asian
|
|
Native Hawaiian or other Pacific Islander
|
|
American Indian or Alaska Native
|
|
56. |
What is your age now?
|
| 3% |
Under 18
|
| 32% |
18 to 24
|
| 48% |
25 to 34
|
| 11% |
35 to 44
|
| 1% |
45 to 54
|
| 0% |
55 to 64
|
| 0% |
65 to 74
|
|
75 or older
|
|
57. |
Are you mail or female?
|
| 21% |
Male
|
| 79% |
Female
|
|
58. |
What is the highest grade or level of school that you have completed?
|
| 0% |
8th grade or less
|
| 1% |
Some high school, but did not graduate
|
| 25% |
High school graduate or GED
|
| 39% |
Some college or 2-year degree
|
| 19% |
4-year college graduate
|
| 15% |
More than 4- year college degree
|
|
59. |
How are you related to the policyholder?
|
| 47% |
I am the policyholder
|
| 52% |
Spouse or partner of policyholder
|
| 0% |
Child of policyholder
|
| 0% |
Other family member
|
| 0% |
Friend
|
| 1% |
Someone else
|
|
60. |
How are you related to the child?
|
| 99% |
Mother or father
|
| 1% |
Grandparent
|
| 0% |
Aunt or uncle
|
| 0% |
Older sibling
|
| 0% |
Older relative
|
| 0% |
Legal guardian
|