Round 1 Instruments
- Written Patient Survey (English version)
A mailed questionnaire used to capture patient level information to assess socio-demographic characteristics, recommended diabetes care services received, and general health status and quality of life measures (SF12 and EQ-5D). It also assesses access to care, patient satisfaction (CAHPS), diabetes education received, as well as, participation in self-care activities, disease management, and financial barriers. The survey consists of 97 questions and takes approximately 45 minutes to complete.
- Spanish Version
Please note, footnote references are for questions in English that our study researchers had translated into Spanish.
- Short Written Patient Survey (English version)
An abbreviated version of the written patient survey described above. This version consists of only 38 questions including skip patterns. Used as a last attempt at data collection and takes approximately 15 minutes to complete.
- Medical Chart Review
Used to collect information from one or more medical records at a patient's primary care provider office. Data captured includes patient medical history, comorbid conditions (Charlson Index), current medications and diabetes care services such as glycosylated hemoglobin tested/frequency, blood pressure assessment, lipids tested/frequency, eye exam, foot exams, aspirin prescription, nephropathy assessment, smoking cessation counseling and other specific diabetes related health information. Medical records abstracted are for a specific review period of 18 months prior to the respondent's survey completion date. Contains 28 questions although many contain multiple parts.
- Medical Chart Review Instructions
Provides detailed directions on how to complete the medical chart review instrument mentioned above.
Health plan and provider group surveys were used to determine how the organizational features of managed care influence processes of care, quality of care, and health outcomes for people with diabetes. Data were collected from 10 managed care organizations who partnered with the 6 Translational Research Centers (TRCs) and 63 provider groups who had patients who completed a baseline TRIAD survey.
- Health Plan Medical Director Survey
Designed to collect information about the organization of health plans. Medical Directors were asked to review the survey in advance of a meeting in order to expedite the interview since some of the questions may require consultation with the organization's business manager and/or the person who is responsible for monitoring the provision of clinical care. Takes approximately 45 minutes to complete. The survey is divided into 7 sections that can be distributed to persons in the organization who can best answer the questions within each section:
- Your Provider Group
- Diabetes Care and Organization and Use of Guidelines
- Patient Reminders and Education
- Organization of Diabetes Specialty Services in Your Medical Group/IPA
- Payment to Primary Care Physicians and Risk Sharing
- Payment to Specialist Providers
- Utilization Management in Your Medical Group/IPA
- Provider Group Medical Director Survey
Designed to collect information about the organization of physician groups. Medical Directors were asked to review the survey in advance of a meeting in order to expedite the interview since some of the questions may require consultation with the provider group's business manager and/or the person who is responsible for monitoring the provision of clinical care. Takes approximately 45 minutes to complete. The survey is divided into 7 sections that can be distributed to persons in the organization who can best answer the questions within each section:
- Your Provider Group
- Diabetes Care and Organization and Use of Guidelines
- Patient Reminders and Education
- Organization of Diabetes Specialty Services in Your Medical Group/IPA
- Payment to Primary Care Physicians and Risk Sharing
- Payment to Specialist Providers
- Utilization Management in Your Medical Group/IPA
