According to the AHRQ documentation, all persons aged 18 and older who are marked by the family respondent as "yes" to DIABETICEV earlier in the MEPS CAPI instrument receive a paper copy of the DCS questionnaire to complete. The first question on the DCS questionnaire repeats the content of DIABETICEV, asking whether a doctor or other health care professional has ever told them that they have diabetes or sugar diabetes. Theoretically, only people with a "yes" response on DIABETICEV should be in universe for DCSDIABDX, and all people who answer "no" to DIABETICEV should be out of universe for DCSDIABDX (because receipt of the DCS is conditional on answering "yes" to DIABETICEV). However, beginning in 2008, there are approximately 20-70 individuals each year who answer "no" to DIABETICEV, but receive the DCS and answer "yes" to DCSDIABDX. Given the stated path to receiving a DCS according to MEPS documentation, it is not clear how these individuals received a DCS and why their answers to DIABETICEV and DCSDIABDX are conflicting. For more information about how a participant should receive the DCS, please see the Diabetes Care Survey user note.

The discrepancies between answers to DIABETICEV and DCSDIABDX begin to appear with Panel 12, the same panel in which the DIABETICEV question was moved from the Quality (Priority Conditions) Supplement Section (PC) to the Priority Conditions Enumeration (PE) Section.

Additionally, DCSDIABDX only takes on values of "yes" or "out of universe." For those who answered "yes" to DIABETICEV and are out of universe for DCSDIABDX, it is not clear if they refused to answer the question or if they erroneously reported having diabetes in DIABETICEV, subsequently received the DCS, and correctly answered "no" to DCSDIABDX.