HCSUS First Follow-Up Questionnaire Table of Contents

Module 1: Introduction

Module 2: Usual Source of Care, Access to Care and Oral Health

Section A: Usual Source of Medical Care
Section B: General Access to Care
Section C: General Oral Health
Section D: Oral Health Knowledge
Section E: Usual Source of Dental Care
Section F: Dental Insurance
Section G: Dental Visits and Treatments
Section H: Dental Care Satisfaction
Section I: Dental Self-Care

Module 3: Tests and Staging

Section A: Lab Stage
Section B: Clinical Stage

Module 4: Symptoms and Treatment

Section A: Symptoms Checklist
Section B: Pain Cascade
Section C: Oral Ulcer Cascade
Section D: Painful Gums Cascade
Section E: Oral Patches Cascade
Section F: Gynecological Care
Section G: Treatments

Module 5: Insurance

Section A: Public Insurance
Section B: Private Insurance
Section C: Clinical Trials

Module 6: Utilization

Section A: Services Used
Section B: Inpatient Hospital Stays
Section C: Nursing Home/Residential Care Stays
Section D: Visits to Emergency Rooms and Urgent Care Centers
Section E: Medical Visits
Section F: Visits During Population Definition Period
Section G: Mental Health Providers
Section H: Other Health Care Providers
Section I: Home Health Services
Section J: Cost of Care and Services
section K: Medications

Module 7: Residential History and Current Health

Section A: Residential History and Migration
Section B: Current Health

Health-Related Quality of Life

Section A: Health-Related Quality of Life
Section B: SF-12

Module 9: Social Support and Coping

Section A: Social Support
Section B: Coping
Section C: Patient Satisfaction

Module 10: Unmet Needs for Medical and Non-Medical Care

Section A: Competing Needs
Section B: Discrimination and Unmet Non-Medical Needs

Module 11: Mental Health

Section A: Generalized Anxiety Disorder
Section B: Panic Attack
Section C: Depression
Section D: Dysthymia
Section E: Drug Dependence
Sectoin F: Alcohol Use

Module 12: Patient Description

Section A: Acculturation
Section B: Employment and Household
Section C: Pediatrics
Section D: Income and Assets

Module 13: Knowledge

Section A: Perceptions About Therapies
Section B: Medication Adherence
Section C: Optimism
Section D: Information Sources
Section E: Knowledge and Decision Making

Module 14: Contact and Tracking Information

Module 15: Provider Consent, Thank You, and Payment