Diabetes Care Survey (DCS)
Overview
The Diabetes Care Survey (DCS) is a self-administered paper-and-pencil questionnaire designed to collect information about how individuals with diabetes care for their diabetes. The DCS is administered to persons aged 18 and older who indiciated that they have been told by a doctor or other health professional that they have diabetes or sugar diabetes (DIABETICEV) earlier in the MEPS CAPI instrument. The participant is handed the DCS by the MEPS interviewer, and can complete the survey and return it to the interviewer in person, mail in the completed survey, or the interviewer can pick it up at a later date.
The Agency for Healthcare Research and Quality (AHRQ) added the DCS to the MEPS in 2000, beginning with respondents in Panel 4 Round 5 and Panel 5 Round 3 of data collection (please see the the user note for more information on the panel design of the MEPS). From 2000 forward, the DCS is conducted annually in Rounds 3 and 5, so members of each panel have two opportunities to participate in the survey.
DCS Variables
The following variables are created from information collected in the DCS:
- DCSDIABDX: Respondent has been told they have diabetes
- DIA1CEXAMYR: Number of exams for A1C hemoglobin, past 12 months
Feet exams for sores or irritations:
- DIAFTEXAMYR: Number of exams for foot sores, past 12 months,
- DIAFTCKNV: Respondent has never had their feet checked,
- DIAFTCKNXYR: Respondent had their feet checked in the subsequent year,
- DIAFTCKCALYR: Respondent had their feet checked in the current calendar year,
- DIAFTCKPVYR: Respondent had their feet checked in the previous year, and
- DIAFTBFPVYR: Respondent had their feet checked before the previous year
Dilated eye exams:
- DIAEYEXNV: Respondent has never had an eye exam,
- DIAEYEXNXYR: Respondent had an eye exam in the subsequent year,
- DIAEYEXCALYR: Respondent had an eye exam in the current calendar year,
- DIAEYEXPVYR: Respondent had an eye exam in the previous year, and,
- DIAEYBFPVYR: Respondent had an eye exam before the previous year
Blood cholesterol level tests:
- DIACHLYRS: Number of years since respondent last had blood cholesterol checked,
- DIACHLNV: Respondent has never had their blood cholesterol checked,
- DIACHLNXYR: Respondent had their blood cholesterol checked in the subsequent year,
- DIACHLCALYR: Respondent had their blood cholesterol checked in the current calendar year,
- DIACHLPVYR: Respondent had their blood cholesterol checked in the previous year, and
- DIACHLBFPVYR: Respondent had their blood cholesterol checked before the previous year
Flu vaccinations:
- DIAFLUYRS: Approximate number of years since respondent last had a flu vaccination,
- DIAFLUNV: Respondent has never had a flu vaccination,
- DIAFLNXYR: Respondent got a flu vaccination in the subsequent year,
- DIAFLCALYR: Respondent got a flu vaccination in the current calendar year,
- DIAFLPVYR: Respondent got a flu vaccination in the previous year, and
- DIAFLBFPVYR: Respondent got a flu vaccination before the previous year
Health problems related to diabetes:
- DIAKIDNPR: Respondent's diabetes has caused kidney problems, and
- DIAEYEPR: Respondent's diabetes has caused eye problems
Diabetes treatment methods:
- DIETFOLLOW: Respondent follows a special diet to manage diabetes,
- DIAPILLS: Respondent is taking pills to treat diabetes, and
- INSULIN: Respondent is taking insulin for diabetes
Method of learning to treat diabetes:
- DIACLASS: Ever took class in diabetes management,
- DIALRNPHN: Respondent received a telephone call to learn how to treat their diabetes,
- DIALRNNP: Respondent learned to treat their diabetes from an appointment with a nurse,
- DIALRNVST: Respondent learned how to treat their diabetes from a visit to their home,
- DIALRNRFR: Respondent learned how to treat their diabetes from a referral to a specialist,
- DIALRNPCP: Respondent learned how to treat their diabetes from a doctor within their primary care practice,
- DIALRNNPC: Respondent learned how to treat their diabetes from a doctor not in their primary care practice, and
- DIALRNINT: Respondent learned how to treat their diabetes by reading about it on the internet
Other:
- DIARESPOND: Respondent status for diabetes supplement, and
- DIACONF: Respondent's confidence in treating their diabetes
Users can view all of the DCS forms for each year on the MEPS survey forms page.
Notes about the Universe
According to AHRQ documentation, MEPS participants receive the DCS based on their response to DIABETICEV, which is fielded in the Priority Conditions Enumeration (PE) section of the CAPI instrument. DIABETICEV reports the response to the question which asks whether the person was ever told by a doctor or other health professional that they had diabetes. Persons with a "yes" response to DIABETICEV then receive the DCS. The first question of the DCS, DCSDIABDX, asks the same question as DIABETICEV. Theoretically, anyone with a "yes" response to DIABETICEV should not answer "no" to having diabetes in DCSDIABDX, and people with a "no" response to DIABETICEV do not receive the DCS and should not be able to answer "yes" to DCSDIABDX. Figure 1 displays the expected flow of how someone receives the DCS:
However, beginning in 2008, there are cases in which individuals in their second year of data collection answer "no" to DIABETICEV, yet still receive the DCS and answer "yes" to DCSDIABDX, as shown in the 2017 example below. All respondents who answered "yes" to DCSDIABDX have a positive DCS weight (DIABWEIGHT), regardless of their response to DIABETICEV.
The appearance of discrepancies between responses to DIABETICEV and DCSDIABDX corresponds with the move of the DIABETICEV question within the CAPI instrument. Prior to Panel 12, who entered MEPS in 2007, DIABETICEV was asked in Rounds 3 and 5 in the Quality (Priority Conditions) Supplement (PC). The Reporting Unit (RU) respondent was instructed to identify all RU members of any age who had been diagnosed with diabetes. The individuals identified as having diabetes were given the DCS. The DCS was distributed to all RU members with diabetes, regardless of age, but only persons aged 18 and older have valid DCS data on the public use files. Beginning in Panel 12, DIABETICEV is asked in the Priority Conditions Enumeration (PE) section of the CAPI. The RU respondent is instructed to identify all RU members with diabetes in Round 1, but is only asked about new RU members in Rounds 2 and 4. In Round 3, the respondent is asked about new RU members and RU members who were in scope sometime during the round and had not been previously identified as having diabetes.
Impact of MEPS Data Collection Structure on the DCS
Due to the overlapping panel design strucutre of MEPS data collection, one annual data file contains data on participants in two different panels. For example, the 2017 FYC file contains data on participants in Panels 21 and 22 of data collection. However, the Panel 21 Round 5 and Panel 22 Round 3 interview can occur in 2018, even though this data is part of the 2017 file. When the DCS asks about when the respondent had their feet checked for sores or irritations, the respondent can report having their feet checked in 2018 (DIAFTCKNXYR), in 2017 (DIAFTCKCALYR), in 2016 (DIAFTCKPVYR), before 2016 (DIAFTBFPVYR), and never (DIAFTCKNV). Therefore, because the interview can occur in 2018, the respondent can report having their feet checked in the year after the primary year of data collection, even though the reference period for the round may technically end in the primary year of data collection. The same logic holds true for the variables listed above under "Dilated eye exams," "Blood cholesterol level tests," and "Flu vaccinations."
For more information about the panel and round structure of MEPS data collection, please see the user note on the MEPS Panel Design.
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