Supplemental Items for the CAHPS Clinician & Group Child Survey 3.0: Patient-Centered Medical Home
Population version: Child
Download these items: English (Word, 30.72 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 and Response Options |
Placement and Other Instructions |
PCMH1. Did this provider’s office give you information about what to do if your child needed care during evenings, weekends, or holidays?
1 __ Yes
2 __ No |
After core question 15 |
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 your child see a specialist for a particular health problem?
1 __ Yes
2 __ No → If No, go to PCMH4 |
After core question 25 |
PCMH3. In the last 6 months, how often did the provider named in Question 1 seem informed and up-to-date about the care your child 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 you and someone from this provider’s office talk about the kinds of behaviors that are normal for your child at this age?
1 __ Yes
2 __ No
|
After PCMH3 |
PCMH5. In the last 6 months, did you and someone from this provider’s office talk about how your child’s body is growing?
1 __ Yes
2 __ No |
After PCMH4 |
PCMH6. In the last 6 months, did you and someone from this provider’s office talk about your child’s moods and emotions?
1 __ Yes
2 __ No |
After PCMH5 |
PCMH7. In the last 6 months, did you and someone from this provider’s office talk about things you can do to keep your child from getting injured?
1 __ Yes
2 __ No |
After PCMH6 |
PCMH8. In the last 6 months, did you and someone from this provider’s office talk about how much or what kind of food your child eats?
1 __ Yes
2 __ No |
After PCMH7 |
PCMH9. In the last 6 months, did you and someone from this provider’s office talk about how much or what kind of exercise your child gets?
1 __ Yes
2 __ No |
After PCMH8 |
PCMH10. In the last 6 months, did you and someone from this provider’s office talk about how your child gets along with others?
1 __ Yes
2 __ No |
After PCMH9 |
