Mar 11, 2011 - 3 n Doctor did not accept my insurance. 4 n Had problems getting to doctor's office. 5 n Couldn't get time off from work. 6 n Didn't know where to ...
Your Experiences with Cancer 03/11/11 Placeholder for Introduction
4. Which of these are reasons you were unable to get medical care, tests, or treatments you or a doctor believed you needed in the last 12 months? Please check all that apply. 1 n 2 n 3 n
1. As far as you know, are you now free of
cancer? That is, you don’t have cancer in any part of your body.
4 n
5 n 6 n 7 n
1 n
Yes 2 n No 8 n I don’t know
8 n 9 n
Couldn’t afford care Insurance company wouldn’t approve or pay for care Doctor did not accept my insurance Had problems getting to doctor’s office Couldn’t get time off from work Didn’t know where to go to get care Couldn’t get child care/adult care Didn’t have time, care/tests/treatment took too long Other reason (please specify below)
2. At any time since you were first diagnosed with cancer, did a doctor or other health professional tell you that your cancer had come back or that you had a new cancer?
4a. Which of these best describes the main reason you were unable to get medical care, tests, or treatments you or a doctor believed you needed in the last 12 months? (CHECK ONLY ONE ANSWER.)
Yes ➔ Enter most recent year: No 8 n I don’t know 1 n 2 n
3. In the last 12 months, were you ever unable
1 n
to obtain medical care, tests, or treatments for cancer or lasting effects of cancer treatment that you or a doctor believed were necessary?
2 n 3 n 4 n
1 n
Yes 2 n No ➔ Skip to question 5 3 n Did not need cancer care in the last 12 months ➔ Skip to question 5
5 n 6 n 7 n 8 n 9 n
Couldn’t afford care Insurance company wouldn’t approve or pay for care Doctor did not accept my insurance Had problems getting to doctor’s office Couldn’t get time off from work Didn’t know where to go to get care Couldn’t get child care/adult care Didn’t have time, care/tests/ treatment took too long Other reason (please specify below)
Please go to page 2 ➔ 1 Medical Expenditure Panel Survey
5. Since your original cancer diagnosis did
6. Did you ever not do any of the following
you have any health insurance that paid for all or part of your medical care, tests or cancer treatment?
for your cancer because your insurance would not cover it? Yes No a. Seeing the doctor of 1 n 2 n your choice b. Getting a second opinion 1 n 2 n c. Receiving medical treatment 1 n 2 n d. Purchasing medication 1 n 2 n e. Having a medical or laboratory or imaging 1 n 2 n (e.g. MRI) test performed f. Going to the facility of 1 n 2 n your choice
1 n
Yes No ➔ Skip to question 8 8 n I don’t know 2 n
7. Were you ever denied health insurance coverage because of your cancer? 1 n
Yes 2 n No
For items 8-11, please check one of the boxes to indicate how strongly you agree or disagree with each statement in relation to your cancer, its treatment or lasting effects of cancer treatment. Strongly Somewhat Neither Somewhat Strongly agree agree agree nor disagree disagree disagree 8. My cancer has caused financial problems or resulted in reduced financial security for my family 1 n 2 n 3 n 4 n 5 n and me
9. I have gone without the medical care I need because it is too expensive
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10. I worry about having to pay large medical bills
11. It is a problem to cover my share of the cost for a medical care visit
Please go to page 3 ➔ 2 Medical Expenditure Panel Survey
12. I had to borrow money, go into debt,
12a. If yes, how much did you borrow
or make other sacrifices to pay for my cancer care.
or how much medical debt did you incur because of your cancer and its treatment?
