MIT Massachusetts Institute of Technology
Medical Task Force - Student Survey

UPDATED MAY 5, 2005

DEMOGRAPHIC INFORMATION

1. What is your marital status?
D1marital=1 -- Married/with partner
D1marital=2 -- Single

2. Do you have children under the age of 25?
D2children=1 -- Yes
D2children=1 -- No [error]

INSURANCE COVERAGE

MIT provides primary medical care in the MIT Medical Department for all students under the Basic Student Medical Plan (Basic Plan). The costs of providing this care are included in your tuition. MIT also requires all students either to purchase the MIT Student Extended Insurance plan (SEI plan) for hospitalizations, surgery, childbirth, prescription drugs, and other services not covered under the Basic Plan or to demonstrate that the student is covered by a comparable insurance plan.

1. Are you covered under the MIT Student Extended Insurance plan?
IN1extend=1 -- Yes
IN1extend=2 -- No

2. If you are covered under another comparable insurance plan (i.e. you have obtained a waiver from the requirement to pay for the SEI) how did you obtain the coverage?
IN2waiver=1 -- Covered under parents' insurance plan
IN2waiver=2 -- Purchased third-party insurance
IN2waiver=3 -- Covered under spouse or partner’s insurance plan
IN2waiver=4 -- Other

If you are NOT covered under the MIT Student Extended Insurance plan, please skip to the end of this page and click Next.

3. If you are covered under the Student Extended Insurance (SEI) Plan, how are the premiums paid? (Choose all that apply)
IN3prem.1=1 -- My parents pay
IN3prem.2=1 -- I pay from my own resources
IN3prem.3=1 -- My scholarship/fellowship covers the costs
IN3prem.4=1 -- The costs are covered by MIT
IN3prem.5=1 -- Other

4. How informed do you feel about the services that are covered by MIT Medical under your specific insurance plan?
IN4informed=1 -- Very well informed
IN4informed=2 -- Somewhat well informed
IN4informed=3 -- Moderately well informed
IN4informed=4 -- Somewhat informed
IN4informed=5 -- Clueless (not at all informed)

Please use the space if you would like to tell us more about the information on covered services that MIT has or has not provided you.
IN5informed.TEXT

6. What has been your overall level of satisfaction with the care that you have received by outside providers covered under the Student Extended Insurance Plan?
IN6outcare=1 -- Excellent
IN6outcare=2 -- Very good
IN6outcare=3 -- Good
IN6outcare=4 -- Fair
IN6outcare=5 -- Poor
IN6outcare=6 -- N/A

7. What has been your overall level of satisfaction with the process for paying the providers or reimbursing you for the costs of care covered by the SEI?
IN7outpay=1 -- Excellent
IN7outpay=2 -- Very good
IN7outpay=3 -- Good
IN7outpay=4 -- Fair
IN7outpay=5 -- Poor
IN7outpay=6 -- N/A

MIT MEDICAL DEPARTMENT

1. What is your general level of satisfaction with the quality of care that you have received from the MIT Medical Department?
MED1caresat=1 -- Excellent
MED1caresat=2 -- Very good
MED1caresat=3 -- Good
MED1caresat=4 -- Fair
MED1caresat=5 -- Poor
MED1caresat=6 -- Not applicable

2. Are you aware of the Patient Advocate (PA) System?
MED2patadv=1 -- Yes
MED2patadv=2 -- No
MED2patadv=3 -- Don't know/remember

3. What is your level of satisfaction in using the Patient Advocate (PA) System to resolve a grievance?
MED3pasat=1 -- Excellent
MED3pasat=2 -- Very good
MED3pasat=3 -- Good
MED3pasat=4 -- Fair
MED3pasat=5 -- Poor
MED3pasat=6 -- N/A (I've never accessed the PA system.)

4. If you've used the PA system, are there any ways in which you would like to see it changed to better represent your needs? Please use the space below to tell us.
MED4pachg.TEXT

5. Do you have a specific doctor who serves as your primary care physician?
MED5pcp=1 -- Yes
MED5pcp=2 -- No. If No, please skip to Question 8 on this page.

6. Do you rely on this physician as your first point of contact in the MIT Medical Department?
MED6rely=1 -- Yes
MED6rely=2 -- No
MED6rely=3 -- Don't know/remember

7. What is your overall level of satisfaction with your primary care physician?
MED7pcpsat=1 -- Excellent
MED7pcpsat=2 -- Very good
MED7pcpsat=3 -- Good
MED7pcpsat=4 -- Fair
MED7pcpsat=5 -- Poor
MED7pcpsat=6 -- I have not had enough experience to provide a rating of him/her

8. If you do not have a specific primary care physician, please check all of the following that were relevant to this decision.
MED8nopcp.1=1 -- I have never needed to see a medical professional at MIT

MED8nopcp.2=1 -- It is generally easier to see whoever happens to be available when I am sick (including using the 24-hour urgent care/walk-in services)

MED8nopcp.3=1 -- I was not satisfied with the primary care physician assigned to me

MED8nopcp.4=1 -- It is too hard to get an appointment with my primary care physician

MED8nopcp.5=1 -- Other, please specify MED8nopcp.6 [textbox]

24 HOUR URGENT CARE/ WALK IN SERVICE

1. Have you used the 24-hour urgent care/walk-in services provided by the Medical Department?
URG1use=1 -- Yes
URG1use=2 -- No. If No, please skip to Question 5 on this page.

2. About how often during a typical year do you utilize the 24-hour urgent care/walk-in service?
URG2often=1 -- 1-5 times
URG2often=2 -- 5-10 times
URG2often=3 -- 11 times or more

3. What is your overall level of satisfaction with the 24-hour/walk-in service?
URG3urgsat=1 -- Excellent
URG3urgsat=2 -- Very Good
URG3urgsat=3 -- Good
URG3urgsat=4 -- Fair
URG3urgsat=5 -- Poor

4. Since you have been at MIT, the quality of 24-hour urgent/walk-in service on campus has:
URG4quality=1 -- Gotten better
URG4quality=2 -- Stayed the same
URG4quality=3 -- Gotten worse

5. Would you use the 24-hour urgent care/walk-in service more often if you could get real-time information about queue-lengths and reserve a place in the queue without first going to the Medical Department?
URG5queue=1 -- I would use it much more often
URG5queue=2 -- I would use it a little more often
URG5queue=3 -- It would have no effect at all on my decision

6. In terms of 24-hour urgent/walk-in service, what do they do well and what could they do better?
URG6improve

7. Many universities do not have a 24-hour urgent care/walk-in service, but rather direct students who are ill to local clinics and hospitals at night and on the weekends. How would you assess the incremental value to you of having a 24-hour urgent care/walk-in service on campus rather than following the alternative practice?
URG7value=1 -- Extremely valuable
URG7value=2 -- Very valuable
URG7value=3 -- Valuable
URG7value=4 -- Minor value
URG7value=5 -- No value at all

MENTAL HEALTH SERVICES

1. Have you made use of MIT's mental health services?
MEN1used=1 -- Yes
MEN1used=2 -- No. If No, please skip to Question 4 on this page.

2. If you have used MIT's mental health services, what is your general level of satisfaction with these services?
MEN2satis=1 -- Excellent
MEN2satis=2 -- Very Good
MEN2satis=3 -- Good
MEN2satis=4 -- Fair
MEN2satis=5 -- Poor

3. Since you have been at MIT, the quality of Mental Health Services on campus has:
MEN3quality=1 -- Gotten better
MEN3quality=2 -- Stayed the same
MEN3quality=3 -- Gotten Worse

4. If you have not used MIT's mental health services, please check off all of the reasons that influenced your decision:
MEN4notused.1=1 -- No need
MEN4notused.2=1 -- Don't expect to receive high quality care
MEN4notused.3=1 -- Difficult to make appointments
MEN4notused.4=1 -- Concerned about confidentiality
MEN4notused.5=1 -- Prefer to use third-party providers
MEN4notused.6=1 -- I have a pre-existing relationship with a mental health provider outside of MIT
MEN4notused.7=1 -- Other, please specify MEN4notused.8 [textbox]

5. In terms of Mental Health Services on campus, what do they do well and what could they do better?
MEN5improve

MIT INFIRMARY

1. Have you or a member of your family ever spent one or more nights in the MIT infirmary?
INF1use=1 -- Yes
INF1use=2 -- No. If No, please skip to Question 4 on this page.

2. If you or a member of your family has stayed in the MIT infirmary, what has been your general level of satisfaction with the care that you received?
INF2satis=1 -- Excellent
INF2satis=2 -- Very Good
INF2satis=3 -- Good
INF2satis=4 -- Fair
INF2satis=5 -- Poor

3. Since you have been at MIT, the quality of services in the MIT infirmary has:
INF3quality=1 -- Gotten better
INF3quality=2 -- Stayed the same
INF3quality=3 -- Gotten worse

4. If you or a member of your family has never stayed in the MIT infirmary, check all of the reasons that were relevant to this decision:
INF4notused.1=1 -- I/we have not had an illness indicating a stay in the infirmary
INF4notused.2=1 -- I/we would rather stay in my room to recuperate
INF4notused.3=1 -- I/we would rather go home if I am sick enough for a stay in the infirmary
INF4notused.4=1 -- I/we am concerned about missing classes/research project
INF4notused.5=1 -- I/we am concerned about the quality of care in the MIT infirmary
INF4notused.6=1 -- Other INF4notused.7 [textbox]

5. In terms of the MIT infirmary, what do they do well and what could they do better?
INF5improve.TEXT

6. A growing number of colleges and universities are closing their infirmaries and using local hospitals and specially designated dorm rooms as alternatives for the kind of inpatient care provided by the MIT infirmary. What is your assessment of the incremental value of having an infirmary on campus and available to students and members of their families covered by the Student Extended Insurance Plan?
INF6value=1 -- Extremely valuable
INF6value=2 -- Very valuable
INF6value=3 -- Valuable
INF6value=4 -- Minor value
INF6value=5 -- No value at all

MIT GYNECOLOGICAL SERVICES

1. Have you or a member of your family made use of MIT’s gynecological services?
GYN1use=1 -- Yes
GYN1use=2 -- No. If No, please skip to Question 4 on this page.

2. What has been your general level of satisfaction with these services?
GYN2satis=1 -- Excellent
GYN2satis=2 -- Very Good
GYN2satis=3 -- Good
GYN2satis=4 -- Fair
GYN2satis=5 -- Poor

3. Since you have been at MIT, the quality of gynecological care has:
GYN3quality=1 -- Gotten better
GYN3quality=2 -- Stayed the same
GYN3quality=3 -- Gotten worse

4. If you have not used MIT's gynecological services, please check off all of the reasons that influenced your decision:
GYN4no.1=1 -- No need, because I am a man and/or no family members use a gynecologist regularly
GYN4no.2=1 -- No need, because I do not use a gynecologist regularly
GYN4no.3=1 -- Don't expect to receive high quality care
GYN4no.4=1 -- Difficult to make appointments
GYN4no.5=1 -- Concerned about confidentiality
GYN4no.6=1 -- Prefer to use third-party providers
GYN4no.7=1 -- I have a pre-existing relationship with a gynecologist outside of MIT
GYN4no.8=1 -- Other, please specify GYN4no.9 [textbox]

5. If basic gynecological services were only provided at the Medical Department on campus, rather than being available in affiliated physicians' off-campus offices, how would your use of these services change?
GYN5oncamp=1 -- I would use much less often
GYN5oncamp=2 -- I would use a little less often
GYN5oncamp=3 -- It would have no effect at all on utilization decisions
GYN5oncamp=4 -- I would use a little more often
GYN5oncamp=5 -- I would use much more often

6. In terms of gynecological services, what do they do well and what could they do better?
GYN6improve.TEXT

MIT OBSTETRICS SERVICES

1. Have you or a member of your family made use of MIT’s obstetrics services for pre-natal care, child birth, or post-natal care?
OB1use=1 -- Yes
OB1use=2 -- No. If No, please skip to Question 5 on this page.

2. What has been your general level of satisfaction with these services?
OB2satis=1 -- Excellent
OB2satis=2 -- Very Good
OB2satis=3 -- Good
OB2satis=4 -- Fair
OB2satis=5 -- Poor

3. If you or a family member has given birth to a child while covered under the SEI plan, what has been your (or your family member's) level of satisfaction with the care provided by the hospital where the baby was delivered?
OB3birth=1 -- Excellent
OB3birth=2 -- Very Good
OB3birth=3 -- Good
OB3birth=4 -- Fair
OB3birth=5 -- Poor
OB3birth=6 -- N/A

4. Since you have been at MIT, the quality of obstetrics care has:
OB4quality=1 -- Gotten better
OB4quality=2 -- Stayed the same
OB4quality=3 -- Gotten worse

5. In terms of obstetrics services, what do they do well and what could they do better?
OB5improve.TEXT

MIT PEDIATRIC SERVICES

1. If you have a child covered by the SEI plan, have you made use of MIT's pediatric services?
PED1use=1 -- Yes
PED1use=2 -- No. If No, please skip to Question 4 on this page.

2. What has been your general level of satisfaction with these services?
PED2satis=1 -- Excellent
PED2satis=2 -- Very Good
PED2satis=3 -- Good
PED2satis=4 -- Fair
PED2satis=5 -- Poor

3. Since you have been at MIT, the quality of pediatric services has:
PED3quality=1 -- Gotten better
PED3quality=2 -- Stayed the same
PED3quality=3 -- Gotten worse

4. If basic pediatric services were only provided at the Medical Department on campus, rather than being available in affiliated physicians' off-campus offices, how would your use of these services change?
PED4campus=1 -- I would use much less often
PED4campus=2 -- I would use a little less often
PED4campus=3 -- It would have no effect at all on utilization decisions
PED4campus=4 -- I would use a little more often
PED4campus=5 -- I would use much more often

5. In terms of pediatric services, what do they do well and what could they do better?
PED5improve.TEXT

MIT DENTAL SERVICES

1. Have you made use of MIT's dental care services?
DEN1use=1 -- Yes
DEN1use=2 -- No. If No, please skip to Question 5 on this page.

2. What is your assessment of the quality of dental care that you received?
DEN2satis=1 -- Excellent
DEN2satis=2 -- Very Good
DEN2satis=3 -- Good
DEN2satis=4 -- Fair
DEN2satis=5 -- Poor

3. Many colleges and universities do not provide on-campus dental care, sending students instead to be cared for by dentists in the community. What incremental value do you place on having an on-campus dental care option rather than being required to seek such care from dentists in the community?
DEN3value=1 -- Extremely valuable
DEN3value=2 -- Very valuable
DEN3value=3 -- Valuable
DEN3value=4 -- Minor value
DEN3value=5 -- No value at all

4. Since you have been at MIT, the quality of dental services has:
DEN4quality=1 -- Gotten better
DEN4quality=2 -- Stayed the same
DEN4quality=3 -- Gotten worse

5. In terms of dental services, what do they do well and what could they do better?
DEN5improve.TEXT

OVERALL ASSESSMENT OF MIT MEDICAL SERVICES

1. As a general matter, what has been your level of satisfaction with obtaining appointments with medical professionals in the MIT Medical Department at convenient times and in a timely fashion?
OVER1satis=1 -- Excellent
OVER1satis=2 -- Very Good
OVER1satis=3 -- Good
OVER1satis=4 -- Fair
OVER1satis=5 -- Poor

2. What is your level of satisfaction with the amount of time it takes to see a specialist and the referral process?
OVER2satis=1 -- Excellent
OVER2satis=2 -- Very Good
OVER2satis=3 -- Good
OVER2satis=4 -- Fair
OVER2satis=5 -- Poor
OVER2satis=6 -- N/A

3. What is your general level of satisfaction with the quality of care that you have received from the MIT Medical Department?
OVER3satis=1 -- Excellent
OVER3satis=2 -- Very Good
OVER3satis=3 -- Good
OVER3satis=4 -- Fair
OVER3satis=5 -- Poor

4. Since you have been at MIT, the quality of services in the Medical Department has:
OVER4quality=1 -- Gotten better
OVER4quality=2 -- Stayed the same
OVER4quality=3 -- Gotten worse

5. Have you tried to access insurance coverage away from MIT (i.e. at home on a study break or while traveling?)
OVER5travel=1 -- Yes
OVER5travel=2 -- No
OVER5travel=3 -- Don't know / remember

6. Please use the space below to tell us about your experiences with accessing insurance coverage away from MIT.
OVER6trav.TEXT

7. Many students are dealing with health-care/insurance for the first time. In the case of international students, many students are using American healthcare for the first time. We'd like to know about whether or not you feel like you understand how to navigate MIT Medical and the insurance plans. Please give us your thoughts on your education/introduction to the MIT Medical system in the space below.
OVER7understand.TEXT

8. How often do you use Nightline (the hotline staffed by undergraduates) to address medical questions?
OVER8nline=1 -- Weekly
OVER8nline=2 -- Once a month
OVER8nline=3 -- Once a semester
OVER8nline=4 -- Only once ever
OVER8nline=5 -- I've never used Nightline

9. Please use the space below to tell us your thoughts about Nightline and whether MIT Medical should play a role.
OVER9nline.TEXT

10. In general, what does the Medical Department do well and what could it do better?
OVER10improve.TEXT

11. Surveys invariably miss issues of importance. If there are topics not covered by the survey that you would like us to consider, please use this space to describe them.
OVER11missed.TEXT