Core Content
The Adult Health Care Access and Utilization section (AAU) contains information on access to health care, dental care, health care provider contacts, and immunizations. The questions pertaining to access to health care include: having a usual place for sick care; having a usual place for routine/preventive care; change in the place of care; reasons for a delay in getting medical care; and the inability to be able to afford medical care. The question about the reason for delaying care focused on such access issues as transportation, getting an appointment, and waiting time prior to actually seeing the doctor. A question on dental care asked about the length of time since last dental visit.
Questions regarding health care provider contacts include visits and other contacts with doctors and other health care professionals during the past 12 months. Questions about doctor visits allow for visits not only from medical doctors but from a variety of other health care professionals including: general doctors; specialists; dentists; orthodontists; oral surgeons; optometrists; ophthalmologists; foot doctors; chiropractors; physical, speech, respiratory or occupational therapists; audiologists; nurse practitioners; physician’s assistants; midwives; obstetricians; gynecologists; psychiatrists; psychologists; psychiatric nurses; and clinical social workers. Moreover, contacts or visits are not restricted to medical doctors or professionals working with/for a medical doctor. Questions asking about surgery or surgical procedures and the number of surgeries are included. Questions about home care also are included and are asked independently of other types of health care visits. The reference period for all health care contacts is the past 12 months. Lastly, a separate question is asked about the number of visits to a hospital emergency room in the past 12 months, and there is a question that asks how long it has been since the sample adult has seen or talked to a doctor.
In 2013 a question about HIV testing (ASIHIVT) which was previously in the AAU section was moved to the Adult Selected Items section (ASI).
U.S. Department of Health and Human Services ● Centers for Disease Control and Prevention ● National Center for Health Statistics Supplemental Questions
There are several supplementary questions related to adult immunizations sponsored by the National Center for Immunization and Respiratory Diseases (NCIRD, CDC) including: flu shot and nasal spray flu vaccine, including month and year received; pneumonia vaccine; hepatitis B vaccine and hepatitis A vaccine, including number of doses; Zoster or Shingles vaccine; and tetanus shot, including if it was given in 2005 or later and whether it included the pertussis or whooping cough vaccine. The questions pertaining to flu shot and nasal spray flu vaccine were also administered to all sample children (see the CFI section).
There were no changes to the flu vaccination questions in the AAU section in 2013. The questions were the same as those used in 2012, 2011, and the latter part of 2010. However, analysts interested in trend analyses should note that, from January-August 2010, the NHIS included additional supplemental questions about the H1N1 flu vaccine, which was offered separately from the seasonal flu vaccine during the 2009–2010 flu season. Information regarding the 2010 flu vaccination data can be found online in the 2010 NHIS Sample Adult Variance Layout Report, AAU Appendix.
Additional supplementary questions inquire whether sample adults ever had chickenpox and if it had been in the past 12 months; ever had hepatitis; ever lived with someone with hepatitis; ever had a chronic or long-term liver condition; and ever traveled outside the United States to countries other than Europe, Japan, Australia, New Zealand, or Canada since 1995.
Additional questions ask sample adults if they currently volunteer or work in a hospital, clinic, doctor’s office, dentist’s office, nursing home or other health care facility and if they provide direct patient care.
Also included are questions that ask sample adults if they have ever received the HPV vaccine and number of HPV shots received.
In 2013, five new supplementary questions sponsored by the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP, CDC) were added to this section and the variables based on responses to the questions include data about having been prescribed medication (ARX12MO); having a blood test for hepatitis B and C and reason tested for hepatitis C (AHEPBTST, AHEPCTST, and AHEPCRES); and age of receipt of first HPV shot (AHPVAGE).
Expanded content on health care access and utilization sponsored by the Office of the Assistant Secretary for Planning and Evaluztion (ASPE, HHS) were first added to the survey in 2011 and have been part of this section since then. The questions are embedded throughout the AAU section, and variables based on the responses to these questions include data about reasons for not having a usual source of care (ANOUSPL1-ANOUSPL9); difficulty finding providers (APRVTRYR, APRVTRFD, ADRNANP, ADRNAI); unmet medical need due to cost
(AHCAFYR5, AHCAFYR6); worry about paying medical bills (AWORPAY); health insurance compared to a year ago (AHICOMP); strategies used to reduce prescription drug cost (ARXPR_1-ARXPR_6); timing of and reasons for emergency room visits (AERVISND, AERHOS, AERREA1R-AERREA8R); place of last medical visit and type of doctor/nurse seen and wait time (AVISLAST, ALASTTYP, AVISAPTN, AVISAPTT, AWAITRMN, AWAITRMT); health information technology use (HIT1A-HIT5A); preventive care screening which include checking for high blood pressure, high cholesterol, colon cancer, testing for diabetes, a pap test, and mammogram (APSBPCHK, APSCHCHK, APSBSCHK, APSPAP, APSMAM, APSCOL); whether doctor mentioned diet or smoking (APSDIET, APSSMKC); care for family member and who will help with long term care (LTCFAM, LTCHELP, LTCWHO1- LTCWHO5); purchase of health insurance in past 3 years and difficulty purchasing insurance (AINDINS, AINDPRCH, AINDWHO, AINDDIF1-AINDDIF2); reasons denied health insurance in past 3 years (AINDENY1- AINDENY3); and reasons did not buy health insurance in past 3 years (AINDNOT1-AINDNOT5).
U.S. Department of Health and Human Services ● Centers for Disease Control and Prevention ● National Center for Health Statistics In addition, beginning in Quarter 4 of 2013, a supplementary question that asked if sample adults had looked into purchasing health insurance through the Health Insurance Marketplace was added. This question was sponsored by the Office of the Assistant Secretary for Planning and Evaluation (ASPE, HHS).
Technical Notes
In 2013, the 2011 supplementary variable names ARXPR_1 through ARXPR_6 were changed to ARX12_1 through ARX12_6 because the universe and/or question text changed.