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Supplemental Items for the CAHPS Clinician & Group Adult Survey 3.0: Patient-Centered Medical Home

Population version: Adult

Download these items: English ( Word, 29.84 KB)

Read about the Patient-Centered Medical Home Item Set.

Users of the CAHPS Clinician & Group 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 Placement and Other Instructions
PCMH1. Did this provider’s office give you information about what to do if you needed care during evenings, weekends, or holidays?
   1 __ Yes
   2 __ No		 After core question 8
PCMH2. 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 6 months, did you see a specialist for a particular health problem?
   1 __ Yes
   2 __ No→ If No, go to PCMH14		 After core question 18
PCMH3. In the last 6 months, how often did the provider named in Question 1 seem informed and up-to-date about the care you got from specialists?
   1 __ Never
   2 __ Sometimes
   3 __ Usually
   4 __ Always		 After PCMH2

Note: Use with PCMH2
PCMH4. Please answer these questions about the provider named in Question 1 of this survey.

In the last 6 months, did someone from this provider’s office talk with you about specific goals for your health?
   1 __ Yes
   2 __ No

 After PCMH3
PCMH5. In the last 6 months, did someone from this provider’s office ask you if there are things that make it hard for you to take care of your health?
   1 __ Yes
   2 __ No		 After PCMH4
PCMH6. In the last 6 months, did you and someone from this provider’s office talk about things in your life that worry you or cause you stress?
   1 __ Yes
   2 __ No		 After PCMH5
Page last reviewed December 2018
Page originally created April 2016

Internet Citation: Supplemental Items for the CAHPS Clinician & Group Adult Survey 3.0: Patient-Centered Medical Home. Content last reviewed December 2018. Agency for Healthcare Research and Quality, Rockville, MD.
https://www.ahrq.gov/cahps/surveys-guidance/item-sets/cg/suppl-pcmh-items-cg-survey30-adult.html

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