Supplemental Access Items for the CAHPS Clinician & Group Survey 3.0: Child

Population version: Child

Download these items: English ( Word [ Microsoft Word file - 31 KB] )

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
AC1. In the last 6 months, how many days did you usually have to wait for an appointment when your child needed care right away?
   __ Same day
   __ 1 day
   __ 2 to 3 days
   __ 4 to 7 days
   __ More than 7 days
After core question 13

Note: Do not insert precodes to the left of check boxes

AC2. In the last 6 months, how many days did you usually have to wait for an appointment for a check-up or routine care for your child?   
   __ Same day
   __ 1 day
   __ 2 to 3 days
   __ 4 to 7 days
   __ 8 to 14 days
   __ 15 to 30 days
   __ More than 30 days
After core question 15

Note: Do not insert precodes to the left of check boxes

AC3. In the last 6 months, did your child need care for yourself during evenings, weekends, or holidays?
   1 __ Yes
   2 __ No → If No, go to core question 16
After AC2

Note: If using AC3, change skip pattern for core question 14 to “If No, go to AC3

AC4. In the last 6 months, how often were you able to get the care your child needed from this provider’s office during evenings, weekends, or holidays?
   1 __ Never
   2 __ Sometimes
   3 __ Usually
   4 __ Always
After AC3

Note: Use with AC3

AC5. In the last 6 months, did you contact this provider’s office with a medical question about your child after regular office hours?
   1 __ Yes
   2 __ No → If No, go to AC7
After core question 17

Note: If using AC5, change skip pattern for core question 16 to “If No, go to AC5

AC6. In the last 6 months, when you contacted this provider’s office after regular office hours, how often did you get an answer to your medical question as soon as you needed?
   1 __ Never
   2 __ Sometimes
   3 __ Usually
   4 __ Always
After AC5

Note: Use with AC5

AC7. In the last 6 months, did your child need to visit this provider's office after regular office hours?
   1 __ Yes
   2 __ No → If No, go to AC9
After AC6
AC8. In the last 6 months, how often were you able to get the care your child needed from this provider's office after regular office hours?
   1 __ Never
   2 __ Sometimes
   3 __ Usually
   4 __ Always
After AC7

Note: Use with AC7

AC9. Wait time includes time spent in the waiting room and exam room. In the last 6 months, how often did your child see this provider within 15 minutes of your appointment time?
   1 __ Never
   2 __ Sometimes
   3 __ Usually
   4 __ Always → If Always, go to core question 18
After AC8
AC10. In the last 6 months, after you checked in for your child's appointment at this provider's office, how often were you kept informed about how long you would need to wait for your child's appointment to start?
   1 __ Never
   2 __ Sometimes
   3 __ Usually
   4 __ Always
After AC9

Note: Use with AC9

Page last reviewed April 2016
Page originally created April 2016
Internet Citation: Supplemental Access Items for the CAHPS Clinician & Group Survey 3.0: Child. Content last reviewed April 2016. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/cahps/surveys-guidance/item-sets/cg/suppl-access-items-cg-survey30-child.html