DUE TONIGHT SPSS

Market Insights

Core Survey

Market Insights measures the opinions and behaviors of healthcare consumers through a syndicated, online survey that is fielded continuously in major markets across the contiguous United States. This resource provides a framework for the range of topics covered by the survey and serves as a guide for clients in accessing data available in the online portal. It is NOT an actual representation of how the survey is experienced by a respondent nor does it represent any personalized questions clients can elect to ask local consumers through their membership. Please use this guide as a reference of the various question sets addressed in the Market Insights survey.

HEALTHCARE SYSTEM

Quality/Image Profile

Quality/Image Summary

What is your first choice hospital/facility for...?

a. Best Accommodations/Amenities _____________ Q0012235 ______________________________________________________________

b. Best Community Health Programs____________ Q0005421 _____________________________________________________________

c. Best Doctors_ _________ Q0005415 ________________________________________________________________________________

d. Best Image/Reputation_ ______ Q0005417 __________________________________________________________________________

e. Best Nurses_____________ Q0005416 ________________________________________________________________________________

f. Best Overall Quality________ Q0005419 ________________________________________________________________________

g. Care For Those Unable To Pay________ Q0005422 ________________________________________________________________

h. Highest Patient Safety ________ Q0024530 ______________________________________________________________________

i. Hospital Most Conveniently Located________ Q0005425 ____________________________________________________________

j. Hospital Web Site Used Most Often _________N/A_______________________________________________________________________

k. Latest Technology and Equipment _ ________ Q0005423 _______________________________________________________

l. Most Personalized Care__________ Q0005418 ___________________________________________________________________

m. Most Preferred for All Health Needs_ _______ Q0005420 ______________________________________________________________

n. Widest Range of Services_ _____ Q0005424 _______________________________________________________________________

Service Line Preference Profile

Service Line Preference Summary

If you or a household member were in need of this service, to which hospital/facility would you prefer to go?

a. Bariatric (Weight Loss) Surgery _ __________ Q0020687 _____________________________________________________________

b. Cancer Treatment________ Q0005436 ________________________________________________________________________

c. Heart Care_ ________ Q0005433 _____________________________________________________________________________

d. Home Health Care _____ Q0005434 __________________________________________________________________________

e. Hospital Emergency Room ____ Q0005430 _____________________________________________________________________

f. Hospital Inpatient Stay _____ Q0005429 _________________________________________________________________________

g. Imaging Services(MRI/CT-PET Scan) _ ___ Q0016922 ________________________________________________________________

h. Maternity/OB _ ___ Q0005437 _________________________________________________________________________________

i. Neurology_ __ Q0009011 ____________________________________________________________________________________

j. Orthopedic Treatment/Surgery_____ Q0005435 _________________________________________________________________

k. Outpatient/Same-Day Surgery____ Q0005431 _____________________________________________________________________

l. Outpatient Testing/X-Rays _____ Q0005432 _____________________________________________________________________

m. Pediatric Services_____ Q0005438 ___________________________________________________________________________

n. Physical Therapy______ Q0006305 ____________________________________________________________________________

o. Plastic Surgery _____ Q0024477 _______________________________________________________________________________

p. Transplants _______ Q0016923 ___________________________________________________________________________

q. Women’s/GYN _ ____ Q0005468 ___________________________________________________________________________

Page 1

Last Visit Share

Last Visit Share

Which hospital/facility was most recently used for...?

a. Hospital Inpatient Stay _______ Q0005449 _______________________________________________________________________

b. Hospital Emergency Room ____ Q0005450 _______________________________________________________________________

c. Outpatient Testing/X-Rays ____ Q0005452 __________________________________________________________________________

d. Outpatient/Same-Day Surgery ____ Q0005451________________________________________________________________

Primary Reason – Inpatient Stay

What is the primary reason you chose that facility for your most recent inpatient visit? (Select one answer.) Q0030645

� Best Overall Quality � Reputation of Facility

� Convenient Location � Your Doctor Recommended/Affiliated

� Facility Has the Best Doctors � Other

· Facility Has the Best Nurses

· Insurance Required to Use That Facility

· Latest Technology and Equipment

· Most Personalized Care

· Previous Experience With Facility

· Recommendation From Family/Friends

Primary Reason – Outpatient/Same Day Surgery

What is the primary reason you chose that facility for your most recent outpatient surgery? (Select one answer.) Q0030646

� Best Overall Quality � Reputation of Facility

� Convenient Location � Your Doctor Recommended/Affiliated

� Facility Has the Best Doctors � Other

· Facility Has the Best Nurses

· Insurance Required to Use That Facility

· Latest Technology and Equipment

· Most Personalized Care

· Previous Experience With Facility

· Recommendation From Family/Friends

Visit Satisfaction

Overall Quality of Care and Services (IP)

How would you rate the overall quality of care and services of (hospital chosen for Inpatient Stay)? Q0000341

� Poor � Fair � Good � Very Good � Excellent

Overall Quality of Care and Services (ER)

How would you rate the overall quality of care and services of (hospital chosen for Emergency Room)? Q0000092

� Poor � Fair � Good � Very Good � Excellent

Overall Quality of Care and Services (OP-S)

How would you rate the overall quality of care and services of (hospital chosen for Outpatient Surgery)? Q0003875

� Poor � Fair � Good � Very Good � Excellent

Overall Quality of Care and Services (OP-T)

How would you rate the overall quality of care and services of (hospital chosen for Outpatient Testing)? Q0004383

� Poor � Fair � Good � Very Good � Excellent

Would Recommend Facility to Family or Friends (IP)

Would you recommend (facility chosen for Inpatient Stay) to family and friends? Q0000336

� Definitely Not � Probably Not � Probably Yes � Definitely Yes

Would Recommend Facility to Family or Friends (ER)

Would you recommend (facility chosen for Emergency Room) to family and friends? Q0000090

� Definitely Not � Probably Not � Probably Yes � Definitely Yes

Page 2

Visit Satisfaction (CONTINUED)

Would Recommend Facility to Family or Friends (OP-S)

Would you recommend (facility chosen for Outpatient Surgery) to family and friends? Q0005588

� Definitely Not � Probably Not � Probably Yes � Definitely Yes

Would Recommend Facility to Family or Friends (OP-T)

Would you recommend (facility chosen for Outpatient Testing) to family and friends? Q0004462

� Definitely Not � Probably Not � Probably Yes � Definitely Yes

Hospital Selection

Top of Mind Awareness

When you think of hospitals in your area, which one comes to mind first?

Name ____________________ Q0005586_______________________________________________________________________________

Hospital Selection

If you had to go to a hospital for a planned overnight stay, using a 5 point scale with “1” being “not at all important” and “5” being “very important”, how important would the following factors be to you when selecting a facility?

How You Would Consider Doctor’s Advice in Selecting a Hospital

Which one of these statements best describes how you would consider your doctor’s advice in selecting a hospital: (Select one answer)

Q0028172

· Hospital my doctor recommends

· State preference but follow doctor’s advice

· Insist on my preferred hospital

Hospital Advertising

Hospital Advertising Recall

Thinking of hospital advertising, which hospital’s advertising comes to mind first?

Name ______________ Q0005426_______________________________________________________________________________________

Where (Ad) Read, Seen, Heard

Where did you read, see or hear that advertisement? (Select one answer) Q0009014

� Billboard � Web Site

� Mailings � Physician’s Office

� Newsletter � Social Network Site (e.g. Facebook)

� Newspaper � Ad on bus/train/subway

� Radio � Other, please specify____________________________________________

� Television

Image Ad Portrays

Did that advertisement have a positive, negative or no influence on your image of the Hospital? (Select one answer) Q0005428

� Positive Influence � Negative Influence � No Influence

Preferred Advertising Method

What is your preferred method for receiving information about hospitals? (Select one answer) Q0024482

� Billboard � Web Site

� Mailings � Physician’s Office

� Newsletter � Social Network Site (e.g. Facebook)

� Newspaper � Ad on bus/train/subway

� Radio � Other, please specify____________________________________________

� Television

Page 3

Hospital Branding

Familiarity With Hospital

Using a 5 point scale with “1” being “not at all familiar” and “5” being “very familiar”, how familiar are you with (facility from Top of Mind)?

Q0009010

� 1 � 2 � 3 � 4 � 5

Top of Mind Awareness Rating Summary

Thinking of (facility from Top of Mind), using the 5 pt. scale with “1” being “worst in the market” and “5” being “best in the market”, how would you rate it against other hospitals in your market on the following...?

Hospital system branding

Top of Mind Hospital System

Thinking of health/hospital systems in your area, which one comes to mind first?

Name _____________ Q009017A_____________________________________________________________________________________

Hospital Utilization that is Part of a Healthcare System Q0040090

Which of the following statements best describes how you feel about using a hospital that is part of a healthcare system?

· I am much more likely to choose a hospital that is part of a health system

· I am somewhat more likely to choose a hospital that is part of a health system

· It makes no difference to me whether or not a hospital is part of a health system

· I am somewhat less likely to choose a hospital that is part of a health system

· I am much less likely to choose a hospital that is part of a health system

Outpatient facility type preference

Type of Facility Preference for Outpatient Services

When in need of outpatient services (e.g. minor surgery, tests/procedures), to what type of facility do you prefer to go? (Select one answer.) Q0020688

· Hospital Outpatient

· Physician’s Office

· Freestanding Facility

· Don’t Know/Unsure

Outmigration of healthcare services

Left Area for Healthcare

In the last three years, have you or anyone in your household had to go outside your area for healthcare services? (Select one answer.)

� Yes � No Q0024479

Hospital Last Used Outside Area

If yes, which hospital/facility did you use last outside your area?

Name ___________ Q0040001_______________________________________________________________________________________

Reasons for Leaving Area for Healthcare

Why did you go outside your area for healthcare services? (Select as many as apply.)

· Services were not offered in your area Q0024480A

· Clinical expertise of facility/provider located outside your area Q0024480B

· Good reputation of facility/provider located outside your area Q0024480C

· Didn’t go outside area for services Q0024480D

Page 4

Outmigration of healthcare services (continued)

Services Used When Left Area for Healthcare

For which of the following services did you leave the area? (Select as many as apply.)

· Bariatric (Weight Loss) Surgery

· Cancer Treatment

· Heart Care

· Home Health Care

· Imaging Services (MRI, CT, PET Scan)

· Maternity/OB Services

· Neurology (Stroke/Brain or Spine Illness/Injury)

· Orthopedic Treatment/Surgery

· Pediatric Services

· Plastic Surgery

· Rehab/Physical Therapy

· Transplants

· Women’s/GYN

· Other

Distance Traveled Outside Area for Care

How many miles did you travel outside your area for those services? (Enter whole number. Please round your answer to the nearest whole number)

__________ X00000143________________________________________________________________________________________________

HEALTH PLANS

HEALTH PLANS

Health Plan Market Share

Household Insurance Coverage

Are you currently covered by any form of health insurance or health plan? (A health plan includes any private insurance plan through your employer or a plan that you purchased yourself, as well as a government program like Medicare or Medicaid.)

HHINSCOVERAGE

· Yes

· No, I am not covered by and health insurance

· Don’t Know

Health Plan Category

Is your PRIMARY health insurance coverage private or government sponsored? X00000152

· Private Insurance - Provided through an employer or purchased independently

· Government Sponsored

· Don’t Know

Health Plan Type

What type of plan is your PRIMARY insurance? HPTYPE

� HMO (Health Maintenance Organization) � Medicaid (Medi-Cal in California)

� PPO (Preferred Provider Organization) � VA, Military or CHAMPUS

� POS (Point-of-Service) � Don’t Know

� Traditional/Indemnity/Fee for service � Other - Please Specify_________________________________________

� Medicare or Medicare Advantage

Health Plan Type

What is the name of your PRIMARY health insurance provider? X00000151

� Aetna � Highmark

� Blue Cross/Blue Shield � Humana

� Blue Cross of California � Independence Blue Cross

� Blue Shield of California � Kaiser Permanente

� Cigna � UnitedHealth Group

� Coventry Health Care � WellPoint

� Health Care Service Corporation (HCSC) � Don’t Know

� Health Net � Other - Please Specify_________________________________________

Page 5

health plan market share (continued)

Uninsured Reasons

Your household is uninsured because: (Select as many as apply.)

· You are healthy Q0024501A

· You don’t need insurance Q0024501B

· You can’t afford the cost of insurance Q0024501C

· Employer does not offer insurance Q0024501D

· Unemployed Q0024501E

· You can’t buy insurance due to a preexisting medical condition Q0024501F

· Medical disability Q0024501G

· Cheaper to pay our of pocket (self-insured) Q0024501H

· Don’t understand plans well enough to purchase insurance Q0024501I

Hospital Selection

If you had to go to a hospital for a planned overnight stay, using a 5 point scale with “1” being “not at all important” and “5” being “very important”, how important would the following factors be to you when selecting a facility?

Current Usage of CDHP or High Deductible Plan

Is your primary health insurance policy a “high deductible policy” or “Consumer Directed Health Plan”? (Select one answer.)

Q0024502

� Yes � No � Don’t Know

PHYSICIAN OFFICE/MEDICAL CLINICS

physician access

Purpose of Household’s Last Physician Visit

Thinking of your HOUSEHOLD’S last physician visit, what was the purpose of this most recent visit? (Select only one.) Q0016941

· Routine care (physical exam or check-up)

· Minor illness/injury (such as sore throat)

· Chronic or ongoing condition

· Urgent Care

· No one in household saw a physician within the last 2 years

Physician’s Specialty During Last Visit

What type of doctor was last seen? (Select only one.) Q0024488

· Family Practice/General Practitioner

· Obstetrician/Gynecologist

· General Internist

· Pediatrician

· Other Specialist

retail/mini clinics – usage and demand

Retail/mini clinics offer an affordable, quick alternative to a physician office visit. They are typically located onsite at a pharmacy or retail chain like CVS, Wal-Mart or Target where certified nurse practitioners diagnose and treat select common family illnesses.

They do not require an appointment, and are typically open seven days a week. Visits are reimbursed by most insurance plans.

Retailed-Based Medical Clinic Utilization

Have you used this type of medical clinic before? (Select one answer.) Q0028176

� Yes � No

Page 6

retail/mini clinics – usage and demand (CONTINUED)

Location of Retail-Based Medical Clinic Used

Where would you most likely use this type of clinic if available? (Select one answer.) Q0028177

· Grocery/Supermarket

· Pharmacy

· Discount Store (e.g., Wal-mart, Target)

· Stand Alone Facility

· Shopping Mall

· Other, please specify____________________________________________________________________________________________

Likelihood to Use Retail-Based Medical Clinic

Using a 1-5 scale, with “1” being “Not at all Likely, and “5” being “Very Likely,” how likely would you be to use this type of clinic in the future? (Select one answer.) Q0028178

� 1 � 2 � 3 � 4 � 5

retail/mini clinic satisfaction

Overall Quality of Care and Services

How would you rate the overall quality of the care and services received at this clinic? Q0028180

� Poor � Fair � Good � Very Good � Excellent

Recommend to Family/Friends

Would you recommend that clinic to family and friends? Q0030648

� Definitely Not � Probably Not � Probably Yes � Definitely Yes

COMMUNITY NEEDS ASSESSMENT

healthcare utilization

Healthcare Utilization

Have you or a household member used any of the following services in the last three years? (Select as many as apply.)

· Hospital Inpatient Stay Q0005439

· Hospital Emergency Room Q0005440

· Outpatient Surgery Q0005441

· Outpatient Testing/Treatment Q0005442

Member of Household Deferred Healthcare in Last Six Months

Have you or anyone in your household delayed any healthcare treatment in the last six months? Q0040026

� Yes � No

Primary Reasons for Delaying Healthcare Treatment

What were the primary reasons for delaying healthcare treatment? (Please select all that apply)

· Concerned about spending during current economy Q0040027A

· Do not have regular/primary physician Q0040027B

· Treatment not covered by health plan Q0040027C

· Healthcare provider does not have convenient hours Q0040027D

· Concerned to take the time off from work Q0040027E

· Problem not serious Q0040027F

· No insurance Q0040027G

· Unable to pay Q0040027H

· Concerned about my co-pay amount or deductible not being met Q0040027I

· No Generic prescription medicine available and co-pay for Brand was too high Q0040027J

· Employed but in waiting period before coverage starts Q0040027K

· Symptoms come and go, willing to manage on my own for now Q0040027L

· No home care giver to support my needs after “the event” (surgery, rehab, sub-acute) Q0040027M

· Other, please specify__ Q0040027N_____________________________________________________________________

Page 7

Chronic Conditions

Has ANY HOUSEHOLD MEMBER been diagnosed as having any of the following health problems? (Select as many as apply.)

· Allergies-Hay Fever Q0009062

· Allergies-Other Q0009063

· Arthritis Q0009065

· Asthma Q0009066

· Attention Deficit Disorder Q0009067

· Cancer (Other than Skin) Q0009068

· Cataract Q0009069

· Chronic Headaches Q0009070

· Chronic Heartburn Q0009071

� Depression/Anxiety Disorder Q0009074

� Diabetes Q0009075

� Eating Disorder Q0009076

� Heart Disease Q0009078

� High Blood Pressure Q0009079

· High Cholesterol Q0009080

· Indigestion/Irritable Bowel Q0009081

· Migraines Q0009082

· No Chronic Condition in Household Q0024532

· Obesity/Weight Problems Q0009083

· Osteoporosis Q0009084

· Other Chronic Condition Not in database

· Sciatica/Chronic Back Pain Q0009086

· Sinus Problem Q0009087

· Skin Cancer Q0009088

· Sleep Problem/Insomnia Q0009089

· Smoker SMOKER

· Stomach Ulcer Q0009090

· Stroke Q0009091

Preventive Health Behaviors

Has ANY HOUSEHOLD MEMBER used or had any of the following health care services or tests in the last 12 months? (Select as many as apply.)

� Blood Pressure Test Q0040020 � Mental Health Screening Q0040025

� BMI (Body Mass Index) Screening Q0040021 � Mammogram Q0009055

� Cardiovascular Stress Test Q0009048 � MRI Q0016955

� Child Immunizations Q0012237 � Osteoporosis Testing Q0009056

� Carotid Artery Screening Q0040022 � Pap Smear Q0009057

� Cholesterol Tests Q0009049 � PET Scan Q0020768

� Colon Screening Q0009050 � Pre-Natal Care Q0009058

� CT-Scan Q0020767 � Prostrate Screening Q0009059

� Eye Exam Q0009051 � Routine Physical Exam Q0009060

� Dental Exam Q0009052 � Stop Smoking Program Q0009061

� Diabetes Screening Q0040023 � Weight Loss Programs Q0020769

� Flu Shot Q0009053 � Other preventive service or test Q0028186

� Hearing Test Q0040024 � No preventive service or test in household Q0028187

household profile

Health Status (Household Level)

In general, would you say the health of each household member is... (Select one answer in each row) Not in database

� Poor � Fair � Good � Very Good � Excellent

Years Lived in Community

How long have you lived in your community? (Select one answer.) YEARSINCOMM

· Less than one year

· 1-2 years

· 2-3 years

· 3-5 years

· 5-9 years

· 10 or more years

DEMOGRAPHIC PROFILE

demographic profile

Respondent Gender

Are you male or female? MEMBERGENDER1

� Male � Female

Respondent Age

What is your age? Age

� 18-34 � 35-44 � 45-64 � 65+

Page 8

demographic profile (continued)

Household Income

What is your annual household income (before taxes)?

HHINCOMECAT

HHINCOMECAT100K [System variable-household income recoded to categories including $100k+]

· Under $25,000

· $25,000 - $49,999

· $50,000 - $74,999

· $75,000 - $99,999

· Over $100,000

Marital Status

What is your marital status? MARITALSTATUS

· Single (Never married)

· Domestic Partnership

· Married

· Separated/Divorced/Widowed

Presence of Children in the Household

How many children do you have living in your household who are under the age of 18? PRESENCEOFCHILDREN

Number of Household Members

Including yourself, how many people live in your household? HHSIZE

Race

What race do you consider yourself? Race

· White

· Black or African-American

· Native American or Alaska Native

· Asian

· Native Hawaiian and Other Pacific Islander

· Other race

· Two or more races

· Don’t know/Prefer not to answer

Hispanic Origin

Do you consider yourself to be of Hispanic/Spanish/Latino descent? HISPANIC

� Yes � No

Highest level of education

Please select the highest level of education that you have completed (Select one answer): Not in database

· Elementary School

· Middle School/Junior High School

· High School

· Some College/University

· Graduated 2-year College

· Graduated 4-year College/University

· Graduate School

· Postgraduate

· Prefer not to say

Page 9

WEB USAGE & SOCIAL MEDIA

web usage

Websites Used for Health Information

Which of the following websites have you used for healthcare information in the past 12 months? (Select as many as apply.)

· AOL Health Q0016956

· MSN Health Q0016960

· WebMD Q0016961

· Yahoo!Health Q0016962

· Health Plan Website Q0016963

· Local Hospital Website Q0016964

· CDC.gov (Center for Disease Control) Q0030786

· Prevention.com Q0040015

· HealthGrades Q00400315

· HealthFinder.gov Q0040040

· Other Q0017011

· Don’t Know Q0028184

· Have not used websites for health information Q0028185

Visited Hospital Website

While using the internet, have you recently visited the website of a hospital or health care provider? Q0050020

� Yes � No

Hospital Website Most Visited

Which hospital or health care provider’s website do you visit the most? Q0050025

Name ____________________________________________________________________________________________________________

Most Important Information

When visiting the website of a hospital or health care provider, what information is most important to you?

· How to find the hospital Q0050023A

· How to find a physician Q0050023B

· The hospital’s mission Q0050023C

· Information on specific diseases Q0050023D

· Emergency room wait times Q0050023E

· Payment/billing information Q0050023F

· Hospital specialty/service lines Q0050023G

· Current hospital news Q0050023H

· Awards and credentials Q0050023I

· Photos of the facility Q0050023J

· Doctor bios Q0050023K

· Live chat/blog with a staff member Q0050023L

· Other, please specify__________ Q0050023M______________________________________________________________

· I don’t visit hospital or health care provider websites Q0050023N

Likelihood to Prefer Hospital Based on Website

If you visit a hospital or health care provider website, how likely would you be to prefer them for future health care services? (With “1” being “Not at All Likely” and “5” being “Very Likely”): Q0050022

� 1 � 2 � 3 � 4 � 5

Mobile Device Utilization

Have you used a mobile handheld device (cell phone, smart phone, tablet – not a desktop or laptop computer) to access health-care-information of any kind? Q0016959

� Yes � No

Website vs. Application

How was the information found on your mobile device? Not in database

· Website

· Application

· Both website and application

· Other, please specify____________________________________________________________________________________________

Future Mobile Device Utilization

In the next 12 months, do you anticipate using a mobile handheld device to access healthcare information of any kind? Q0050005

� Yes � No Page 10

social media

Social Media Utilization

Do you use social media (e.g. Facebook, Twitter, YouTube, etc.)? Q0050011

� Yes � No � Don’t Know

Mentioned/Discussed Hospital

While using social media, have you mentioned or discussed a hospital or health care provider? Q0050012

� Yes � No

Interacted Directly With Hospital

While using social media, have you interacted directly with a hospital or health care provider? (This would include liking or fol-lowing a hospital) Q0050013

� Yes � No

Mentioned/Discussed/Interacted With Hospital

While using social media, which hospital or health care provider do you mention, discuss, or interact with the most? N/A

Name ____________________________________________________________________________________________________________

Forms of Social Media Used

What form of social media do you use as a source of health information? Q0050017

· Facebook Q0050049A

· Twitter Q0050049B

· YouTube Q0050049C

· MySpace Q0050049D

· FourSquare Q0050049E

· Pinterest Q0050049F

· LinkedIn Q0050049G

· Instagram Q0050049H

· Vine Q0050049I

· Other, please specify_____ Q0050049J______________________________________________________________

Activities Performed

Which of the following activities do you perform when using social media for health information?

· Search for health information Q0050018A

· Share stories about your healthcare experience Q0050018B

· Rate the quality of care received from a healthcare provider Q0050018C

· Keep others informed of your healthcare status or the healthcare status of a family member Q0050018D

· Ask for doctor/hospital recommendations Q0050018E

· Ask for health advice Q0050018F

· Raise the awareness of health information Q0050018G

· Fundraising for a health-related cause Q0050018H

· Seek out support from others with similar health issues Q0050018I

· Other, please specify_________ Q0050018J ______________________________________________________

· None of the above Q0050018K

Likelihood to Prefer Hospital Based on Social Media

If you mention, discuss, or interact with a hospital or health care provider while using social media, how likely would you be to prefer them for future health care services? (With “1” being “Not at All Likely” and “5” being “Very Likely”): Q0050015

� 1 � 2 � 3 � 4 � 5

Social Media as a Source of Health Information

Do you use social media (e.g. Facebook, Twitter, YouTube, etc.) as a source of health information? Q0050016

� Yes � No � Don’t Know

Level of Trust and Confidence in Information Received

How would you rate your level of trust and confidence in the health information you receive through social media from hospitals or health care providers? (With “1” being “Very Low” and “5” being “Very High”): Q0050019

� 1 � 2 � 3 � 4 � 5

Page 11

BrandArc

BrandArc questions are not available to all clients due to varying levels of membership within Market Insights. Consult your Account Manager if you have questions about your level of access. All of the BrandArc questions refer to the facility named for Top of Mind Awareness on the survey and are automatically populated by this facility name when presented to the respondent.

presence

Top of Mind Other Mentions

Thinking of other facilities that you would use, which other hospital/facility would you prefer most to use?

Name ________ N/A_______________________________________________________________________________________

Name _________ N/A______________________________________________________________________________________

distinction

Overall Quality of Hospital

How would you rate the overall quality of (Top of Mind facility)? Q0040055

� Poor � Fair � Good � Very Good � Excellent

Unique/Different Hospital Is From Other Hospitals in Area

Using a 5 point scale with “1” being “not at all unique/different” and “5” being “very unique/different”, how unique/different is (Top of Mind Facility) from other hospitals in the area? Q0040086

� 1 � 2 � 3 � 4 � 5

Hospital Differentiators

Based on anything you have read, heard, or know from personal experience, what factors, if any, stand out in your mind as things that (Top of Mind Facility) does especially well that sets it apart from other providers in the area? (Select as many as apply.)

· Caring and compassionate doctors and nurses Q0040087

· New and advanced technology and equipment Q0040088

· Strong image/reputation Q0040089

· Better doctors and nurses Q0040045

· Participates in my health plan Q0040046

· Convenient locations/Easy access/Proximity Q0040047

· Faster emergency room service/treatment Q0040048

· Expertise in all fields Q0040049

· Award Winning Q0040050

· Community Involvement Q0040051

· Other, please specify____ Q0040052_____________________________________________________

· Nothing Q0040053

· Don’t know Q0040054

value

Hospital Momentum

Based on your own experience and perceptions, which of the following best describe (Top of Mind Facility)? Q0040056

· It is really on the way up

· It is on the way up

· It is not moving

· It is on the way down

· It is really on the way down

· Not sure/don’t know

Relevance of Hospital

Using a 5 point scale with “1” being “not at all relevant” and “5” being “very relevant”, how relevant is (Top of Mind Facility) to you personally? Q0040057

� 1 � 2 � 3 � 4 � 5

Image/Reputation Rating

Thinking of (Top of Mind Facility), using the 5 pt. scale with “1” being “worst in the market” and “5” being “best in the market”, how would you rate it against other hospitals in your market on the following...? (Image/Reputation) Q0040071

� 1 � 2 � 3 � 4 � 5

Page 12

relationship

Hospital Brand Personality

If (Top of Mind Facility) were a person, how would you describe your relationship with them? (Please select a single response)

Q0040058

· Acquaintance - Knowing of them but not close to them

· Kinship/Affinity - Having an inherent liking or connection with them

· Casual Buddy - Sharing a fondness for them but without long-term commitment to them

· Childhood Friend - A relationship formed years ago that is looked upon with nostalgia

· Best Friend - The strongest possible kind of friendship

· Courtship - A period in a relationship where wooing takes place

· Marriage of Convenience - A marriage contracted for reasons other than relationship, family, or love

· Committed Partnership - A long-term voluntary union that is reciprocal in nature

· Dependency - A feeling that they are irreplaceable

· Aversion/Hostility - A desire to avoid them

· Love-Hate - A personal relationship involving simultaneous or alternating emotions of love and hostility

· Enslavement - Feeling you have no choice but to use them

· None of the above

· Don’t Know

Most Preferred Other Hospital for Utilization

Thinking of other facilities that you would use, which other hospital/facility would you prefer most to use? Q0040066

Name ____________________________________________________________________________________________________________

Willingness to Switch Insurance Plans/Doctors To…

Please select how much you agree or disagree with each of the following statements.

· I would switch health insurance plans to go to a hospital or medical center I prefer Q0040059

· I would switch health insurance plans to go to a doctor or physician group I prefer Q0040060

· I would pay more to go to a hospital or medical center I prefer Q0040061

· I would pay more to go to a doctor or physician group I prefer Q0040062

· I would switch doctors or physician groups to go to the hospital I prefer Q0040063

Used Hospital in Last Three Years

Have you or a household member used (Top of Mind Facility) for any services in the last three years? Q0040064

� Yes � No

loyalty

Hospital Selection Sensitivity

Which of the following best describes how strong you feel about using (Top of Mind facility)? Q0040065

· It is the only hospital I would use

· I prefer it, but I would consider another hospital if I had to

· I would use it, but I do not feel that strongly about it

· I would use it, but would prefer to go somewhere else

· I would not use it

Most Preferred Other Hospital for Utilization

Besides (Top of Mind Facility), when you think of additional hospitals/facilities in your area, which other one comes to mind next?

Name _____ Q0040067____________________________________________________________________

Name _____ Q0040068___________________________________________________________________

Would Recommend Facility to Family or Friends (Overall)

Would you recommend (facilities chosen for Inpatient Stay, Emergency Room, Outpatient Surgery, Outpatient Testing) to family and friends? Not In database

� Definitely Not � Probably Not � Probably Yes � Definitely Yes

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Questions in Dataset But Not in Questionnaire